Several NHS trusts are reportedly moving ahead with policies that appear to conflict with the Supreme Court’s ruling on transgender rights, particularly around access to single-sex spaces.
West London NHS Trust is among those allowing biological males with a Gender Recognition Certificate (GRC) to use female-only wards and toilets, despite the court’s interpretation of “sex” under the Equality Act 2010 as referring to biological sex.
According to its guidance, patients may access single-sex facilities based on their “legal gender”, meaning that trans women holding a GRC could be admitted to women-only areas.
Critics say this effectively overrides the Supreme Court judgment, which they understand as confirming that people born male should not be permitted in female-only spaces.
The trust, which provides services across Ealing, Hounslow and Hammersmith and Fulham and runs women-only mental health units at St Bernard’s Hospital, has drawn particular scrutiny.
Claire Coutinho, the shadow equalities minister, called the approach “astonishing” and said it was not lawful. She argued that women in hospitals—often in vulnerable circumstances—need clear guarantees that privacy and safety in single-sex spaces will be protected.
She also urged the Health Secretary to intervene and withdraw the policy, saying national NHS guidance remains overdue more than a year after the ruling.
Whistleblowers who reviewed the documents said the language used was deliberately unclear, making it difficult to see how single-sex provision is actually being applied.
Sex Matters director Fiona McAnena criticised the policy, saying “legal gender” is not a valid legal or medical term and accusing the trust of attempting to work around equality law. She warned the approach could lead to legal challenges and be copied by other trusts if left unchanged, and called for clear national guidance from NHS England.
Women’s rights campaigners also warned the policy could weaken protections for single-sex spaces.
In response, the trust said the policy is temporary while it awaits national guidance. It said it had taken legal advice and aimed to balance the rights of all protected groups while maintaining safe and effective care.
The trust added that it updated its transgender policy in April and would revise it again once NHS England issues further direction.
The Equality and Human Rights Commission has stated that, for Equality Act purposes, legal sex refers to biological sex at birth and that obtaining a GRC does not change that definition.
An NHS spokesperson said updated statutory guidance from the commission has been presented to Parliament and is currently under review, with draft health service guidance expected soon.
