NHS introduces new rules protecting single-sex hospital wards

NHS England has announced new guidance requiring transgender patients to be accommodated on hospital wards according to their biological sex, rather than their gender identity.

The updated guidance, published on Thursday 15 October, means that biological males who identify as women should no longer be accommodated on female-only wards, while biological females who identify as men should not be placed on male-only wards.

The changes reverse previous NHS guidance, which allowed transgender patients to be accommodated according to their gender identity.

However, the guidance makes clear that clinical needs must take priority. Where placing a transgender patient on a ward corresponding to their biological sex would not be clinically appropriate, hospitals will be expected to make alternative arrangements, while protecting the privacy and dignity of everyone involved.

Following the Supreme Court ruling

The changes come 18 months after the Supreme Court ruled unanimously that the terms 'woman' and 'sex' in the Equality Act 2010 refer to biological sex.

The landmark judgment, delivered in April 2025, provided greater legal clarity over the provision of single-sex spaces and services, including those intended to protect women's privacy, dignity and safety.

The new NHS guidance reflects that ruling, reaffirming the importance of maintaining single-sex accommodation while ensuring all patients receive appropriate medical care.

The rules will apply across NHS acute, mental health and community services, as well as NHS-funded care provided in private settings. Accident and emergency departments, urgent treatment centres and paediatric services are not covered by the accommodation guidance.

Campaigners welcome the decision

The announcement has been welcomed by women's rights campaigners, who have long argued that biological sex must be recognised when providing intimate spaces such as hospital wards and changing rooms.

Bethany Hutchison, a nurse who successfully challenged County Durham and Darlington NHS Foundation Trust over its policy allowing a transgender colleague to use female changing facilities, welcomed the announcement as "clear and necessary guidance from NHS England".

However, she warned: "The test now is whether NHS trusts will actually follow it."

Maya Forstater, chief executive of the women's rights organisation Sex Matters, described the decision as "a momentous shift back to reality".

The changes have also faced criticism from transgender campaign groups, who argue they could discourage transgender people from seeking medical treatment.

The announcement marks a significant shift in NHS policy, reinforcing the legal recognition of biological sex and the importance of protecting single-sex spaces, while requiring healthcare providers to ensure that every patient receives safe and dignified care.