NHS Under Pressure to Update Guidance Following Supreme Court Ruling on Single-Sex Spaces

The Equality and Human Rights Commission (EHRC) has warned that the NHS and other public bodies will be expected to follow new legal guidance on the definition of single-sex spaces, following a landmark UK Supreme Court ruling.

The ruling, delivered unanimously by the court, confirms that "woman" under the Equality Act refers specifically to biological sex. This means that the possession of a Gender Recognition Certificate (GRC) no longer changes an individual’s legal sex for the purpose of accessing women-only spaces and services.

Baroness Kishwer Falkner, chair of the EHRC, said the body has been in ongoing discussions with the health service, but would now demand action.

“We will be asking them when they plan to update their advice,” she told the BBC. When asked if the EHRC would take steps to enforce compliance, she responded, “Yes, we will.”

NHS Guidelines Set to Change

Currently, NHS policy allows trans individuals to be housed in wards aligned with their gender identity, taking into account their names, pronouns, and clothing. That guidance will now need to be revised under the updated legal interpretation.

The EHRC says it is “working at pace” to update its official code of conduct for services, including the NHS, prisons, and domestic shelters, with the expectation that new guidance will be in place by summer.

The judgment could have significant implications for how services handle access to hospital wards, public toilets, changing rooms, and other spaces typically segregated by sex.

Court Ruling and Its Broader Impact

The case, brought by women’s rights advocates, argued that sex-based protections under UK law should apply exclusively to people born female. The Supreme Court agreed, stating that biological sex is the only coherent definition within the Equality Act.

The ruling also allows for single-sex spaces to be legally restricted, stating that a trans woman—regardless of legal gender status—does not have an automatic right to access women-only areas.

Baroness Falkner said the ruling preserves dignity for all, adding:

“Single-sex services like changing rooms must be based on biological sex. If a male person is allowed in, it’s no longer a single-sex space.”

She also encouraged the creation of “third space” facilities to serve trans individuals, offering more inclusive options without compromising existing sex-based rights.

Mixed Reactions Across the UK

Scottish Greens MSP Maggie Chapman, a vocal supporter of trans rights, criticized the ruling as fuelling cultural division.

“This will stoke the fires of the culture war. Trans people are now fearful of losing access to spaces they’ve used for decades,” she said.

Trans rights groups say they are reviewing the judgment and considering their next legal options.

Meanwhile, the UK government welcomed the decision, with Health Minister Karin Smyth saying the ruling brings “clarity and confidence” to both service providers and the public.

“This is not about culture wars,” she said. “It’s about ensuring dignity, privacy, and legal clarity for everyone.”

Smyth confirmed that the government is reviewing the ruling and will work with equality organisations to ensure full compliance across all public services.

The new legal definition is also expected to influence other sectors, including women’s sport, where transgender participation has become a high-profile issue.