A joint statement from TransActual and Trans+ Solidarity Alliance
Yesterday NHS England published new guidance on NHS staff facilities which bars trans staff from single-sex toilets, changing rooms and shower rooms that align with their lived gender. The guidance tells NHS Trusts and ICBs not to wait for the EHRC Code of Practice for Workplaces, and instead to implement the ‘principles’ in the Code of Practice for Services, Public functions and Associations. The NHS – the UK’s largest employer – is now becoming an unsafe workplace for trans staff.
The new guidance makes it clear that suitable facilities should be available for trans staff and does not suggest that trans men should use women’s facilities or trans women should use men’s facilities. Instead, trusts and ICBs are encouraged to audit their premises and consider building works, but without additional funding attached. In the cash strapped NHS, it seems likely many healthcare settings will not be able to provide the facilities trans staff now need. Once again, employers are being given impossible instructions and trans people will pay the price.
The impact of this policy will fall on trans workers, who will be at risk of being ‘outed’ to their peers. Trans people have good reason to wish to keep their trans status private at work. Indeed, the 2025 NHS Staff Survey found that a quarter of trans staff working in the NHS had experienced harassment, bullying or abuse from colleagues in the past year.
Trusts and ICBs will carry high litigation risks, both from trans staff protecting their right to a safe working environment and from staff who want to see the exclusion of their colleagues strictly enforced. They may also face significant bills for building works, which without additional investment, will require cuts to services.
And patients will suffer, as trans healthcare workers will have to take longer breaks to access the limited facilities they are now allowed to use.
The NHS already has recruitment and retention issues and this guidance will do little to attract or retain trans staff that are vital to providing healthcare services, and are part of the diverse workforce that NHSE claims to value. These NHS policies are draconian, unnecessary and deeply harmful to trans staff and to our struggling National Health Service.