NHS assessment warned single-sex ward guidance could delay care for trans people

NHS England's own internal assessment warned that its new guidance on single-sex hospital wards could leave trans people facing delays to treatment and a greater risk of 'corridor care', according to reporting by The Guardian.

The guidance tells hospital trusts in England that single-sex wards, toilets and changing rooms should be used on the basis of biological sex, not gender identity. Trans people should be accommodated in line with their biological sex, while ensuring clinical needs are met and privacy, dignity and safety are maintained. The BBC separately reported that trans patients should be cared for in single-sex wards or bays that align with their biological sex, in coverage published on 15 October.

The assessment, which The Guardian said it had seen, warned of delays and a greater risk of 'corridor care' for trans people, with a negative impact on physical and mental health if side rooms are not available. It said hospitals may lack capacity to provide side rooms when needed. In those cases, trans people would be placed on wards aligned with their biological sex.

It also warned that trans people may fear and potentially experience discrimination by being 'outed' as trans through not being accommodated in a ward aligning with lived gender or being placed in a side room. That experience of discrimination, the assessment said, could lead some people to avoid seeking healthcare at all.

The document pointed to wider effects. It said the policy might have a negative impact on fostering good relations between cisgender and transgender people. Cisgender means people whose gender identity matches the sex they were recorded as at birth. It also said some women who did not present in line with general societal expectations could face questioning about their sex to gain access to single-sex wards.

The assessment set out limits and possible mitigations. It said negative impacts could be reduced by prioritising clinical need. The policy does not apply in accident and emergency departments or intensive care. Delivery of same-sex accommodation should not be a reason for corridor care, and decisions about placing trans people should be made on a case-by-case basis.

The guidance follows a 2025 ruling by the UK Supreme Court that 'woman' and 'sex' in the Equality Act, the law that prohibits discrimination based on protected characteristics, refer only to a biological woman and biological sex. That definition does not include transgender women with gender recognition certificates, the legal documents that recognise a change of gender. The updated code of practice from the Equality and Human Rights Commission, the body that enforces equality law, said services must be used on the basis of biological sex and acknowledged that trans people are likely to be disadvantaged by this compared with non-trans people.