Transgender patients to be placed on wards according to their birth sex, NHS England decides

Transgender patients should be placed on hospital wards according to their birth sex rather than their gender identity, according to new guidance.

The updated instructions, published by NHS England on Thursday, mean hospitals should not assign trans women to female wards and trans men to male wards, with "alternative arrangements" to be made only if this was not "clinically appropriate".

Previously, trans patients could stay in a single-sex ward based on the gender with which they identified.

All patients "should be treated with respect, dignity, compassion and care", the report said, adding that "trans people and others with the protected characteristic of gender reassignment should be accommodated in line with their biological sex".

It adds that "where clinical needs and same-sex accommodation requirements cannot both be met, clinical needs are the priority".

The guidance acknowledged that cases where a trans patient was placed on a ward of their gender identity are likely to be "rare".

Acute, mental health and community NHS trusts, as well as NHS-funded patients in private settings, are impacted by the new advice, but A&E departments, urgent treatment centres or paediatrics are not.

NHS England staff working in hospitals and GP surgeries are told that single-sex facilities such as changing rooms and toilets should be used according to biological sex.

In trusts with mainly single-sex facilities, the advice is to think about whether alternatives, "such as single‑occupancy or mixed-sex facilities with individual lockable rooms can be provided to allow access to facilities in a way that respects privacy and dignity and supports inclusion of all staff".

The updated guidance comes just over two months after wider advice on single-sex spaces, written by Britain's rights watchdog, officially came into force, and 18 months since the Supreme Court ruling on biological sex.

The Equality and Human Rights Commission code had already confirmed that a service must be used on the basis of biological sex for it to be classed as single-sex under the Equality Act.

Nurse Bethany Hutchison, who led and won a claim against County Durham and Darlington NHS Foundation Trust after a trans colleague was allowed to use women's changing facilities, welcomed the "clear and necessary guidance from NHS England".

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She said: "The test now is whether NHS trusts will actually follow it."

Campaign groups TransActual and Trans+ Solidarity Alliance said in a joint statement that the guidance "leaves individual healthcare professionals unclear on how to safely look after trans patients".

The statement added: "Forcing trans people into spaces for our sex assigned at birth will never be the most clinically appropriate decision, and would push trans people away from accessing care."

Maya Forstater, chief executive of sex-based rights charity Sex Matters, called it "a momentous shift back to reality", but warned: "NHS patient data is a mess, with potentially thousands of trans-identifying people recorded as the opposite sex."

(c) Sky News 2026: Transgender patients to be placed on wards according to their birth sex, NHS England decides