Sex is biological fact, NHS declares in landmark shift against gender ideology
Campaigners welcome change to constitution, which will ban trans women from female-only wards, as ‘return to common sense’
Laura Donnelly, HEALTH EDITOR30 April 2024 • 12:01am
The NHS is to declare that sex is a matter of biology in a landmark shift against gender ideology.
Changes to the health service’s written constitution proposed by ministers will for the first time
ban trans women from women-only wards, and give women the right to request a female doctor for intimate care.
The NHS constitution, a document that aims to set out the principles and values of the health service and legal rights for patients and staff, was last updated in 2015. It has to be updated at least every 10 years by the Secretary of State.
Campaigners for women’s rights welcomed the significant shift, 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.
The new constitution will state: “We are defining sex as biological sex.”
The clarification means that the right to a single-sex ward means 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 complained that they were forced to share sleeping space with trans women – those who are born male but identify as female.
Women’s rights campaigners said the move was a “return to common sense and an overdue recognition that women’s wellbeing and safety matter.”
However, 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 the NHS’s gender identity services found evidence that allowing children to change gender was built on weak foundations.
Dr Hilary Cass, a paediatrician, said allowing “social transitioning” for young people – when they are treated as the opposite gender – could “change their trajectory” and lead to them
pursuing a potentially damaging medical pathway in later life.
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. It is named after 13-year-old Martha Mills, who died in 2021 after medics missed signs of sepsis and failed to heed warnings from her parents that their daughter’s condition was getting worse.
Women will also be given the right to request that intimate care is provided, where reasonably possible, by someone of the same biological sex.
It follows warnings that some female patients have been
pressured into accepting such care from trans-identifying staff who were born male.
The proposed changes will also see discrimination requirements updated, 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 like “chestfeeding” and “people who give birth”.
In February, Ms Atkins highlighted her concerns, telling The Telegraph: “We need to be making this robust case to refuse to wipe women out of the conversation.”
On Tuesday, she said: “We want to make it abundantly clear that if a patient wants same-sex care they should have access to it wherever reasonably possible.
“We have always been clear that sex matters and our services should respect that.
“By putting this in the NHS constitution we’re highlighting the importance of balancing the rights and needs of all patients to make a healthcare system that is faster, simpler and fairer for all.”
Maya Forstater, 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 – at the heart of principle 1, which sets out that the NHS must treat everyone with equality and respect for their human rights.
“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.
“Sex, of course, is a matter of biology, not identity, and it is welcome that the NHS is now spelling this out in relation to single-sex accommodation and intimate care.”
Ms Forstater said too many female patients seeking that intimate care be given 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 the shift was “simply a return to common sense and an overdue recognition that women’s wellbeing and safety matter.”
Matthew Taylor, 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 to reduce inequalities.
“Whatever changes are eventually introduced following the consultation need to be clear and workable for NHS staff, who should not expect to have to interpret ambiguous guidance at a local level.”
The eight-week consultation will be the first stage of a review of the constitution.
The Government will consider responses from everyone, including the public, clinicians and medical professionals, patients, carers and organisations representing patients and staff and health stakeholders, before publishing the consultation response and the new NHS constitution.
Louise Ansari, chief executive of Healthwatch England said: “The NHS constitution plays a crucial role in shaping the culture of our NHS and helping the public to know their rights.
“Since the NHS constitution launched, it has helped to shift the balance of power from services towards patients and their families. But, with only a third of people knowing their rights, there is still a long way to go.
“Given the challenges our NHS faces, a conversation to reaffirm and raise awareness of the most important rights to the public has never been more timely.
“We urge everyone to take part in the consultation and have their say. This is your opportunity to send a clear message about the rights you hold most dear.”
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