NHS England’s Own Assessment Warns Single-Sex Ward Policy Could Harm Trans Patients

Internal report flags risk of delays, “corridor care” and discrimination, while citing benefits for privacy, dignity and safety of other patient groups

London, October 18, 2026: New NHS England guidance requiring single-sex hospital wards to be used on the basis of biological sex could lead to delays in care, a higher risk of patients being treated in hospital corridors, and discrimination against transgender people, according to the health service’s own internal impact assessment, which has been seen by The Guardian.

The assessment examined how the new guidance on single-sex spaces would affect people across all protected characteristics, including age, disability and sex. It concluded that the policy’s emphasis on privacy, dignity and safety for men and women, together with greater legal accuracy, would have a positive effect. It also identified benefits for pregnant and breastfeeding women, people with certain religious beliefs and some minority ethnic groups.

However, the report acknowledged a “number of potential adverse impacts for trans people”. It warned that where side rooms are unavailable, trans patients could face delays and be left in corridors, harming their physical and mental wellbeing. It added that trans people might fear or experience discrimination, including being effectively “outed” when placed on a ward that does not match their lived gender or moved into a side room, and that this could discourage some from seeking healthcare altogether.

The document further noted that hospitals may lack the capacity to provide side rooms when needed, leaving trans patients to be placed on wards aligned with their biological sex. It cautioned that the policy could strain relations between transgender and non-transgender people, as staff might have to weigh the needs of one group against another, and that some women who do not conform to conventional appearance could face questions about their sex before being admitted to single-sex wards.

NHS England published the guidance on Thursday, instructing trusts that single-sex wards, toilets and changing rooms should be used according to biological sex rather than gender identity, while ensuring trans patients’ clinical needs are met and that their privacy, dignity and safety, and that of other patients, are maintained.

The change follows the UK Supreme Court’s April 2025 ruling that the terms “woman” and “sex” in the Equality Act 2010 refer to biological sex, and the subsequent updated code of practice from the Equality and Human Rights Commission, which recognises that trans people are likely to be disadvantaged by the requirement.

According to the impact assessment, the negative effects could be reduced by always prioritising clinical need and by deciding on the placement of trans patients on a case-by-case basis. It stressed that the provision of same-sex accommodation should never be a reason for corridor care, and noted that the policy does not apply in A&E or intensive care.

NHS England declined to comment on the report.