BMA challenges NHS sex-based guidance and urges consultation on trans patients’ access
The British Medical Association has criticised new NHS guidance requiring hospitals to accommodate patients according to biological sex, saying it could exclude transgender and non-binary staff and patients. The union supports access to NHS accommodation and services according to gender, and wants hospitals reviewing their policies to consult trade unions and trans and non-binary workers.
The guidance also requires staff to use changing rooms and toilets aligned with their birth sex. It follows an April 2025 Supreme Court ruling that “woman” and “sex” in the Equality Act refer to biological sex, and subsequent guidance from the Equality and Human Rights Commission. It covers acute, mental health and community NHS trusts, and NHS-funded care in private settings, but excludes A&E, urgent treatment centres and paediatrics.
In short
- The BMA has challenged new NHS single-sex guidance.
- The rules say patients should be accommodated by biological sex.
- They exclude A&E, urgent treatment and paediatrics.
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The case for
Supporters of the guidance argue that sex-based accommodation gives effect to the Supreme Court’s interpretation of the Equality Act and provides clear, consistent rules for hospitals. They say sex-separated facilities can protect privacy, dignity and safety, particularly for patients in vulnerable settings, while the guidance’s exclusions preserve flexibility in urgent and paediatric care.
The case against
Critics argue that assigning access by birth sex can exclude trans and non-binary patients and staff from facilities where they feel safe, and may undermine their dignity and access to care. They say hospitals should consult unions and trans and non-binary workers when reviewing policies, so services can meet legal duties while taking account of individual needs and practical impacts.
Explained simply
The NHS provides care through hospital, mental health and community services, as well as some care delivered by private providers. Hospitals also set rules for shared facilities such as wards, toilets and changing rooms, where questions about sex and gender can affect how patients and staff are accommodated.
The British Medical Association (BMA) is a trade union and professional body for doctors. Transgender people have a gender identity different from the sex recorded at birth; non-binary people do not identify only as men or women. The NHS guidance concerns both access to facilities and how staff and patients are treated.
The Equality Act is a UK law that protects people from discrimination, including on grounds of sex and gender reassignment. A 2025 Supreme Court ruling addressed how “woman” and “sex” are defined under the Act, and the Equality and Human Rights Commission issued guidance afterwards. These legal and workplace rules shape how NHS organisations make policies for patients and staff.
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Originally published by Daily Mail as “Militant doctors’ union criticises NHS single-sex guidance and backs hospitals allowing trans women on to female wards”.