An NHS trust in London is allowing biological males who hold gender recognition certificates to use women-only wards and facilities, despite a landmark Supreme Court ruling that established the term “sex” in equality law refers to biological sex, the Daily Telegraph has revealed.
West London NHS Trust, which runs mental health services across Ealing, Hounslow, and Hammersmith and Fulham — including women-only units at St Bernard’s Hospital — updated its transgender policy in April and instructed patients they can use single-sex facilities based on their “legal gender.” The policy explicitly states this can include those with a gender recognition certificate, meaning a person born male who holds such a certificate would be permitted to access women-only spaces.
Critics say the policy directly contradicts the Supreme Court’s April 2025 ruling, which the Equality and Human Rights Commission has confirmed means “a person’s legal sex is the one that was recorded at their birth” and that “obtaining a GRC does not change your legal sex for Equality Act purposes.”
One woman who examined the policy documents told the Telegraph they were “full of complicated phrases designed to baffle people into thinking they’re getting single-sex spaces when they are not.” A campaigner added that the guidance tells staff the privacy and dignity of women “is not reason to exclude a trans-identifying male patient from a women’s ward,” and that patients with a GRC “do not have to inform us” they hold one, with staff instructed not to ask patients to produce the certificate.
Shadow equalities minister Claire Coutinho described the policy as “astonishing” and unlawful. “Biological males must not be allowed into single-sex female spaces, but more than a year on from the Supreme Court ruling, the Government has completely failed to get a grip on public services that are still flouting the law,” she said. “Many women and girls in hospital will be particularly vulnerable and need to know that their safety and privacy is being protected. The Health Secretary must demand the immediate withdrawal of this policy, and issue the new national guidance that is more than a year overdue.”
The disclosure comes after a biological male identifying as a trans woman was jailed earlier this month for performing a sex act in front of nurses at the University Hospital of Wales in Cardiff. The 62-year-old, now known as Paula Stanton, was at the hospital after being deemed at risk of self-harm.
Fiona McAnena, director of campaigns at Sex Matters, warned that if the policy were allowed to stand, other NHS trusts could follow suit. “The term ‘legal gender’ has no basis in law or medicine, and it’s extraordinary that NHS bosses at West London think that they can test the law by writing rules using bogus terminology,” she said. “A patient or staff member could have a good case if they decided to challenge the trust in court. But it shouldn’t take legal action by individuals for public institutions to ignore demands from trans activists and fulfil their legal obligations.”
A spokesman for West London NHS Trust said the policy was “a temporary version while we await national NHS guidance” and that it “reflects the Supreme Court ruling,” adding that legal advice had been used to balance the rights of protected groups while maintaining safe and effective care. An NHS spokesman said the EHRC’s statutory guidance had been laid in Parliament and that draft guidance for the health service would be published “shortly.”
The Telegraph has previously reported that all NHS trusts in England were in breach of the law due to outdated guidance on single-sex spaces, with no evidence that any trust has yet updated its guidance to fully comply with the Supreme Court ruling.
