The NHS England impact assessment, obtained by the Guardian, evaluates new guidance stating that single-sex spaces such as wards, toilets, and changing rooms should be used based on biological sex rather than gender identity. While the policy aims to improve privacy, dignity, and safety for men and women, and is expected to benefit groups like pregnant women, people with religious beliefs, and ethnic minorities, the report acknowledges significant risks for trans individuals.
Potential adverse impacts include delays in care, a greater likelihood of corridor care if side rooms are unavailable, and the possibility of discrimination. Trans people may fear being outed if not accommodated in a ward aligning with their lived gender, or if placed in side rooms. The report warns that hospitals may lack capacity for side rooms, forcing trans people into distressing situations on wards aligned with their biological sex. Additionally, the policy could harm relations between cisgender and transgender people, as staff balance needs between groups.
The guidance follows a 2025 Supreme Court ruling that "woman" and "sex" in the Equality Act refer to biological sex, and an updated Equality and Human Rights Commission code. NHS England emphasises clinical need should be prioritised, and that the policy does not apply in A&E or intensive care. Decisions are to be made on a case-by-case basis. NHS England declined to comment.