The NHS Confederation has quietly withdrawn its “pro-trans” workplace guide.
The move follows the April 2025 Supreme Court judgment confirming that “sex” in the Equality Act refers to biological sex, not gender identity.
As a result, any advice telling staff to let people choose toilets or changing rooms according to self-identified gender is now unlawful.
Women’s-rights campaigners say the withdrawal is overdue and demand a public apology.
Supreme Court decision that changed the law
The unanimous ruling clarified that trans women—those born male—must use male single-sex spaces unless venues provide unisex alternatives.
Judges found that ignoring biological sex undermines the Equality Act’s protection for women’s privacy and dignity.
The Equality and Human Rights Commission (EHRC) issued interim guidance urging all employers to review policies immediately.
Why the NHS Confederation withdrew its guidance
The scrapped guide had instructed hospital managers to let staff and patients use facilities matching their gender identity, not birth sex.
It also urged a “zero-tolerance” stance on so-called transphobia, branding anyone who quoted the law as hostile.
A spokesperson admitted the document became “dated” once the Supreme Court and EHRC spoke, so removing it avoided confusion.
The group pledges to rewrite the guide once national codes are updated and approved by ministers.
Reactions from women’s-rights campaigners
Maya Forstater of Sex Matters called the policy “hostile, humiliating and unsafe” for workers and patients.
She says nurses in Darlington were disciplined simply for asking managers to respect single-sex wards.
Campaigners want the NHS Confederation to write every trust, telling them to scrap local rules based on the faulty advice.
Implications for NHS staff and patients
Trusts must now ensure female toilets, showers and wards remain single-sex unless they are expressly unisex.
Managers who punish employees for citing the Equality Act risk legal challenge.
Trans and non-binary staff can still access gender-neutral or accessible facilities where provided.
What comes next for updated guidance
Health Secretary Wes Streeting wants a fully revised policy ready before the end of summer 2025.
Until then, trusts should rely on the EHRC interim note and the Equality Act’s single-sex service exceptions.
Other public bodies are already following suit: the Football Association now bars trans women from women’s competitions.
Key takeaways on the NHS trans guidance ruling
The Supreme Court has settled that sex in UK equality law means biological sex.
The NHS Confederation’s old guide conflicted with that ruling and is gone.
Hospitals must restore lawful single-sex spaces while balancing care for trans and non-binary patients.
Further national guidance is expected within months to give frontline staff clarity.