Sex is a biological fact, NHS declares

Trans women banned from female wards under changes welcomed by campaigners

THE NHS will today declare that sex is a matter of biology, in a significant shift against gender ideology.

Changes to the health service’s constitution proposed by ministers will for the first time ban trans women from female-only wards, and give women the right to request a doctor of the same sex for intimate care.

The constitution, updated every 10 years, aims to set out the principles and values of the NHS and the legal rights for patients and staff.

Campaigners for women’s rights welcomed the move, which comes after years of wrangling and follows accusations that the health service had been captured by “gender ideology”.

In 2021, NHS guidance said trans patients could be placed in single-sex wards based on the gender with which they identified. But under the new proposals, the constitution will state: “We are defining sex as biological sex.”

The clarification means that patients would “not have to share sleeping accommodation with patients of the opposite biological sex”. Until now, no commitment was made to biological sex, meaning some female patients were forced to share sleeping space with trans women – who are born male.

Women’s rights campaigners said the move was “common sense” and recognition that women’s safety mattered.

But NHS leaders raised concerns that the health service was being “dragged into a pre-election culture wars debate”.

The changes to the constitution are a further indication of a change in attitudes after the Cass review into NHS gender identity services found evidence that allowing children to change gender was built on weak foundations.

The updates to the constitution will also include the introduction of a duty to help patients get back to work and embed “Martha’s rule” into the framework of the health service. This follows pledges by Victoria Atkins, the Health Secretary, to give families the right to access a rapid review from an outside team if a patient is deteriorating.

The pledge is named after 13-year-old Martha Mills, who died after medics missed signs of sepsis and failed to heed warnings from her parents that their daughter’s condition was getting worse.

The proposed changes will also update discrimination requirements, with the word gender replaced with sex.

Gender reassignment remains a protected characteristic, meaning that a transgender patient could be given their own room in a hospital to protect their right to a single-sex service.

The document also places a duty on health providers to use “clear terms” to communicate and take account of biological differences. It follows pledges from ministers to stop NHS trusts using terms such as “chestfeeding” and “peo- ple who give birth”.

Maya Forstater, the chief executive of gender-critical group Sex Matters, said: “It is excellent news that the NHS constitution is being revised to put ‘sex’ in its rightful place.

“The confusion between ‘sex’ and ‘gender’ in official policies like the NHS constitution is what has enabled women’s rights to be trampled over in the name of transgender identities.”

Ms Forstater said too many female patients seeking intimate care by a woman had been pressured into accepting a trans-identifying male instead.

“Healthcare providers have become confused and frightened by the idea that a gender recognition certificate, or even just a personal identity claim, overrides other people’s rights when it comes to same-sex care from healthcare

professionals,” she said. She added that the shift was “simply a return to common sense and an overdue recognition that women’s wellbeing and safety matter”.

Matthew Taylor, the chief executive of the NHS Confederation, which represents healthcare leaders, said its members would review the proposals in detail. However, he added: “What is absolutely clear at this stage is that a focus on high-quality care for all is maintained and that the NHS is not dragged into a pre-election culture wars debate. This is not where energies should be focused.”

Mr Taylor said staff worked hard to show fairness and compassion towards all patients. “In particular, groups of people, including trans and non-binary patients, continue to receive some of the worst health outcomes of any group in our society and NHS leaders and staff will want to do all they can to support these patients, as well as their trans and non-binary staff.”

The NHS constitution, a document outlining the rights of patients and staff, was last updated in 2015. It has to be updated at least every 10 years by the Secretary of State. The eight-week consultation will be the first stage of a review of the constitution.

For the first time, the constitution will set out an expectation that staff will provide help for patients to get back to work or to stay in employment. The shift follows a wider Government drive to reduce the welfare bill.

The proposed document will say work is “an important determinant of health” on individuals.