New NHS England policy for trans people could have ‘a number of adverse impacts’, report finds

Trans people could face delays and a greater risk of “corridor care” under new NHS England guidance that means they will no longer be able to use same-sex wards, according to an internal report.

An NHS England impact assessment, seen by the Guardian, stated that trans people may also potentially experience discrimination and this could lead to them “avoiding accessing healthcare at all”.

The document considered the impact of new NHS guidance on single-sex spaces across all protected characteristics, including age, disability and sex. It said the policy’s focus on “privacy, dignity and safety for men and women” would have a positive impact, as would the legal accuracy in guidance on single-sex spaces.

It also highlighted benefits for women who are pregnant or breastfeeding, people with certain religious beliefs and minority-ethnic groups.

But it said there were a “number of potential adverse impacts for trans people”, adding: “There may be delays and a greater risk of ‘corridor care’ for trans people with a negative impact on their physical and mental health and wellbeing if side rooms are not available.

“Trans people may fear and potentially experience discrimination by being ‘outed’ as trans through not being accommodated in a ward that aligns with their lived gender or being placed in a side room.”

It said there was a risk that hospitals would not have the capacity to provide side rooms when needed, “forcing trans people into the potentially distressing situation of being accommodated on wards aligned with their biological sex”.

It said the new policy might have a “negative impact on fostering good relations” between cisgender and transgender people, as staff may need to “balance the needs of one group against the other” and this could create animosity and division.

It also said some women who did not “present in line with general societal expectations” could be subjected to questioning around their sex in order to access single-sex wards.

NHS England published new guidance for trusts on Thursday stating that single-sex wards, toilets and changing rooms should be used by people based on their biological sex, not their gender identity.

It stated that trans people should be “accommodated in line with their biological sex” while ensuring their clinical needs were met and their “privacy, dignity and safety are maintained”, along with other patients sharing their accommodation.

A supreme court ruling in 2025 that stated the terms “woman” and “sex” in the Equality Act referred only to a biological woman and to biological sex, and did not include transgender women with gender recognition certificates.

The updated Equality and Human Rights Commission (EHRC) code of practice for services said they must be used on the basis of biological sex, and acknowledged that “trans people are likely to be disadvantaged by this, by comparison to people who are not trans”.

The NHS England impact assessment said negative impacts of the new policy could be mitigated by ensuring clinical need is always prioritised, and it highlighted how the new policy does not apply in A&E or intensive care.

It said the delivery of same-sex accommodation should not be a reason for patients to receive “corridor care”, and that decisions on where to place trans people should be made on a “case-by-case basis”.

NHS England declined to comment.