An NHS trust has come under criticism after introducing a policy that continues to allow transgender patients with Gender Recognition Certificates (GRCs) to access single-sex hospital facilities according to their acquired gender, despite last year’s landmark Supreme Court judgment on the definition of sex under equality law.
The issue was first reported by The Telegraph, which revealed that West London NHS Trust has adopted interim guidance stating that patients may be admitted to single-sex wards based on their “legal gender”, including where an individual holds a Gender Recognition Certificate.
The policy applies across the trust’s services in Ealing, Hounslow, and Hammersmith and Fulham, including mental health facilities such as St Bernard’s Hospital, which operates female-only units. The trust also runs the high-security Broadmoor Hospital in Berkshire.
The development has reignited debate over how public bodies should implement the Supreme Court’s April 2025 ruling, which found that the term “sex” in the Equality Act 2010 refers to biological sex.
The judgment was widely interpreted as confirming that protections for single-sex spaces are based on biological sex rather than gender identity. The ruling followed a lengthy legal challenge brought by campaign group For Women Scotland.
Under West London NHS Trust’s updated policy, admissions to wards are determined by sex registered at birth or reflected on official documentation, including a Gender Recognition Certificate. The guidance states that transgender men and women will ordinarily be admitted according to their “legal gender” unless there is an objective justification for an alternative arrangement.
The policy further states that excluding a transgender patient from a single-sex service should be exceptional and only undertaken where it can be justified as a proportionate means of achieving a legitimate aim.
Critics argue that the approach conflicts with guidance issued by the Equality and Human Rights Commission (EHRC), which has stated that obtaining a Gender Recognition Certificate does not alter a person’s legal sex for the purposes of the Equality Act following the Supreme Court ruling.
The EHRC has advised that, for Equality Act purposes, legal sex remains the sex recorded at birth, regardless of whether an individual possesses a Gender Recognition Certificate.
Shadow Equalities Minister Claire Coutinho described the trust’s policy as “astonishing” and called on ministers to intervene.
She said women and girls in hospital settings, many of whom may be particularly vulnerable, should be confident that their privacy and dignity are being protected. She also urged the Government to publish updated national guidance for public services.
Campaign group Sex Matters also criticised the policy. Fiona McAnena, the organisation’s director of campaigns, argued that the trust was attempting to maintain practices that had effectively been overturned by the Supreme Court’s interpretation of equality law.
The controversy comes amid broader questions about how NHS organisations should implement the ruling. The Telegraphpreviously reported that many NHS trusts continue to operate under older guidance that predates the Supreme Court judgment and allows transgender patients and staff to use facilities corresponding with their gender identity.
NHS England has yet to publish revised national guidance. The organisation has said it is reviewing the EHRC’s updated statutory code and intends to issue draft guidance to the health service in due course.
A spokesperson for West London NHS Trust defended the policy, describing it as a temporary measure pending national direction.
The trust said it had sought legal advice when drafting the guidance and believed it reflected the Supreme Court judgment while balancing the rights of different protected groups and ensuring safe and effective patient care.
An NHS England spokesperson said the EHRC’s statutory guidance had now been laid before Parliament and was being reviewed ahead of the publication of updated guidance for NHS organisations.
The issue remains politically contentious, with campaigners on both sides of the debate arguing that clear national guidance is now needed to ensure a consistent approach across the health service.
Worth reading in full here: https://www.telegraph.co.uk/news/2026/06/28/nhs-hospitals-ignore-single-sex-space-ruling/
