Letter to Wes Streeting about hospital wards

26^th September 2025

Dear Wes,

We are writing to you following your recent comments regarding trans people’s experience in the NHS.

We absolutely share your stated commitment to trans people’s dignity, safety and belonging and welcome your acknowledgement of the discriminatory and harmful ways in which trans people have been treated within the NHS.

However, this commitment and acknowledgement is contradicted by the views you have expressed around trans people in hospital. We were particularly disappointed by the assertions you made both at the NHSE LGBT+ Conference and in conversation with Mumsnet that trans people cannot be safely included in single sex spaces within healthcare settings.

There remain regular instances, as a result of NHS capacity and resource constraints, that patients are not able to be placed into wards that are appropriate to their needs, as you identify. Considering these existing challenges, how will it be possible to ensure there are segregated spaces within already overstretched hospitals available for trans people to use, and that no discrimination against the transgender people is happening at the same time?

You also state that it would be undignified for many trans people to use a ward in line with their sex assigned at birth, which may have no relevance to their gender presentation today.

If this is the case, it is clear that as things stand, the implementation of the proposed EHRC Code of Practice would effectively prevent trans people from accessing hospital care altogether. This is clearly an unworkable, discriminatory, violation of human rights, and dangerous outcome.

We must ensure that everyone’s healthcare needs and dignity are being met in hospitals. At the NHSE LGBT+ Conference you stated that policy decisions should be evidence based, but there is no evidence to suggest that it is necessary to change the existing policy on the accommodation of trans people in hospital wards.

An unpublished review of the policy (which has been in place since 2019) found many issues, none of them relating to trans people. Equally, FOI requests of NHS Trusts revealed that trans people have been accommodated in wards according to their lived gender without any significant complaints.

HSSIB’s investigation into safety on mental health inpatient wards found that the only safety issues linked to trans people were linked to them being kept safe from cisgender patients. We are aware of an incident that occurred just this month, where a trans woman was sexually assaulted by a male patient when she was being accommodated on a men’s ward.

By mandating access to wards according to someone’s sex assigned at birth, we open the door to invasive questioning and harassment of anyone who doesn’t conform to gender norms. Our recent Trans Segregation report has clearly demonstrated a rise in such harassment incidents, affecting both those who are trans, and those who are not, since the Supreme Court judgement.

The NHS 10 Year Plan talks of an NHS which is designed to tackle inequalities in both access and outcomes, giving everyone, no matter who they are, the means to engage with the NHS on their own terms. As such, we are asking that you follow through on your ambitions to ensure trans people are treated with dignity in the NHS, and take a common sense approach, that has worked for years, that allows trans people to continue using wards according to their lived gender.

Yours sincerely,

Chay Brown, Director of Healthcare

Tammy Hymas, Policy Lead

TransActual

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