This week several civil-service departments finally released new policies on trans-identifying civil servants, and on 15th October NHS England also released a new policy on single-sex hospital wards. These replace trans-activist influenced policies that were out of line with both the Equality Act and other people’s rights.
The civil-service policies will directly affect around 500,000 civil servants, as well as 185,000 military personnel and are likely to have a wider impact on decision-making by government bodies and regulators. The policies we have seen restore single-sex spaces but retain unclear and worrying gender-identity language, and suggest impractical constraints on the recognition of sex.
Single-sex wards
The NHS constitution for England promises that “if you are admitted to hospital, you will not have to share sleeping accommodation with patients of the opposite sex, except where appropriate”. The handbook to the constitution sets out further details. Patients should not have to share sleeping accommodation with people of the opposite sex and should have access to segregated bathroom and toilet facilities. Patients should not have to pass through opposite-sex areas to reach their own facilities. Women in mental-health units should have access to women-only day spaces. Accident and emergency and children’s wards are mixed sex.
NHS England has adopted revised guidance on privacy, dignity and safety in hospital accommodation, which covers same-sex accommodation for patients and guidance on NHS staff facilities. It makes clear that separate accommodation on the basis of sex means biological sex. It says:
“To maintain hospital accommodation as single sex under the Equality Act 2010, trans people and others with the protected characteristic of gender reassignment should be accommodated in line with their biological sex.”
A breach of the same-sex accommodation guidance occurs at the point when one (or more) of the following principles is not met:
Women should not have to share sleeping accommodation with men. Men should not have to share sleeping accommodation with women.
Women should not have to share toilet or bathroom facilities with men. Men should not have to share toilet or bathroom facilities with women.
Women should not have to walk through an area occupied by men to reach toilets or bathrooms, excluding corridors. Men should not have to walk through an area occupied by women to reach toilets or bathrooms, excluding corridors.
Women-only day rooms should be provided in mental-health inpatient units.
The guidance on NHS staff facilities makes clear that single-sex facilities are provided on the basis of sex, and employers should ensure they provide enough facilities so that no one is left without a suitable one.
The guidance on patients says that where it would not be clinically appropriate to deliver care to a trans patient on a ward or bay that aligns with their biological sex, providers should identify alternative arrangements, and where clinical needs and same-sex accommodation requirements cannot both be met clinical needs are the priority.
The same-sex wards guidance follows changes to NHS data standards made in July 2026 to record biological sex accurately.
Departmental policies and guidance
Government departments and agencies have released their own policies and guidance for staff, based on a common model produced by the Cabinet Office. This has not yet been published. The departmental versions we have seen including from the Department for Work and Pensions, HMRC, Ministry of Defence, Government Legal Department and Office for National Statistics say that trans-identifying civil servants and service personnel are not permitted to use single-sex facilities or accommodation for the opposite sex, and that a gender-recognition certificate does not alter a person’s sex for the purposes of accessing single-sex facilities. This is in line with the judgment in For Women Scotland.
However the guidance documents also say that the words “he” and “she” refer to gender, not sex, and define “misgendering” as a term used to describe the use of a word “that does not correctly reflect the gender with which they identify”. For example, “it may be misgendering to use the terms man or woman when referencing a trans colleague if this refers to their sex at birth.”
Several versions of the guidance say a deliberate attempt to “deny” or “invalidate” a person’s trans identity is unacceptable behaviour and could result in disciplinary action. But at the same time they say that “there are occasions when it may be legitimate to refer to a person’s sex, for example, in a discussion about access to single-sex spaces.”
The HMRC guidance says terms “transman” and “transwoman” (without a space) are described as offensive and its staff are told not to use them. It warns that “terms that were once accepted can quickly become outdated and offensive”.
Several versions of the guidance also continue to say (we think wrongly) that a person’s “gender history” is special-category data, and that a person does not have to disclose their sex at work.
Guidance says that when an individual informs their line manager or commander of their intention to transition they should be advised that “accommodating their needs will need to be balanced with those of their colleagues and the business”.
If colleagues are concerned about someone using the wrong facilities they are told they should raise a concern by speaking to a manager and “not confronting or challenging the colleague directly”. While this is good advice for avoiding conflicts between employees, it will only work to ensure compliance if management acts promptly and firmly in response to complaints. Examples such as the case of Eleanor Frances, who says she was subjected to a sustained pattern of unfair treatment at the DCMS after she complained about an unlawful policy, show just how far government departments have to go in fixing their culture in order to implement these policies.
Single-sex facilities must be based on sex
These policies are a significant step forward. NHS England’s previous same-sex accommodation policy operated on the basis of gender self-identification, set out in “Annex B” to the NHS constitution. This told hospitals that they must allow trans and non-binary people to choose opposite-sex wards. The previous civil-service policy said staff may “use any appropriate single-sex toilets and other facilities” based on “gender identity and expression”.
Pressure not to bring these policies in line with the law has been strong, with LGBT+ networks arguing that preventing trans-identifying civil servants from accessing single-sex facilities for the opposite sex was “transphobic” and “completely unacceptable”. However the law is clear and it is high time that the civil service was required to accept and respect it.
These changes come after months of delay. In January 2026 the chief operating officer of the civil service wrote to us that the Cabinet Office was “reviewing the 2019 policy to ensure it remains legally compliant”. It clearly wasn’t, as it has now been replaced.
This should not be done quietly, but clearly and openly, with the model policy and departmental policies published, and with an apology for getting it so wrong for so long.