NHS England changes hospital ward guidance for transgender patients

Transgender patients should normally be accommodated in hospital wards and bays corresponding to their biological sex under updated guidance issued by NHS England.

The change reverses previous guidance which allowed patients to be placed according to their gender identity. Where this is not clinically appropriate, healthcare providers have been told to consider alternatives such as a single room while protecting the privacy, dignity and safety of everyone involved.

NHS England has made clear that clinical need must take priority when it cannot be reconciled with same-sex accommodation requirements. Decisions about individual patients will therefore still require clinical judgement rather than an automatic approach in every circumstance.

The guidance also applies to staff facilities, including toilets, changing rooms and showers. NHS organisations are expected to review their provision and offer suitable alternatives, which may include single-occupancy or mixed-sex facilities containing private, lockable rooms.

The change follows the Supreme Court’s 2025 ruling that references to sex in the Equality Act 2010 mean biological sex. While some campaigners have welcomed the clarification, transgender organisations and the British Medical Association have raised concerns about its practical implementation and the possibility of trans and non-binary people feeling excluded from healthcare.

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