Doctor 'enraged' over NHS transgender ward policy

A row has erupted over NHS policies which allow transgender women onto women-only wards.

A consultant psychiatrist at Greater Manchester Mental Health NHS Foundation Trust (GMMH) claims a patient, who identified as a trans woman, exposed themselves to female patients during their stay.

Greater Manchester Mental Health NHS Foundation Trust (GMMH) said it had investigated the allegations and had no record of this ever happening.

The case highlights the fact that the NHS still has no national policy reflecting legal changes which say single-sex services must reflect biological sex.

Earlier this month, The Times reported that the psychiatrist, who has not been named, had filed a tribunal claim with the Advisory, Conciliation and Arbitration Service (Acas) in August.

She said she had raised repeated concerns with GMMH over its trans inclusion policies, which are likely to be in breach of a Supreme Court ruling given 17 months ago.

In April 2025, the court ruled that the terms "man" and "woman" referred to biological sex when it came to applying the 2010 Equality Act.

The newspaper's report prompted Shadow Health Secretary Damian Hinds and Shadow Equalities Minister Joy Morrissey to write to the trust's chief executive seeking urgent answers about safeguarding.

The consultant, who has been anonymised as "Dr A", told the BBC that a consultant colleague said in a meeting that the patient, who had a beard and male genitalia, had been placed on the women-only ward.

She said she was told that the patient exposed themselves to others on the ward. Three female patients, she said, had complained about what had happened.

She added that another colleague had told her that staff had previously objected to the patient being on the ward, but had been overruled by senior managers.

"I put no blame on the patient who was admitted to the female ward," she said, adding that some mental illnesses could lead to patients becoming sexually disinhibited.

But she added that the situation had led to her feeling "enraged" at the hospital trust's policies.

"They are among the most vulnerable people in our society – mentally ill women. They're detained, they've got no choice, no agency," she said.

GMMH said that it had no record of this incident, or one like it, ever happening and if such information was provided to them it would be appropriately investigated.

It added that it was aware that there was a reported incident at another hospital trust, which it did not name, which fitted the description.

Dr A's case centres on a wider claim that NHS trusts are continuing to treat trans women, biological males who identify as women, in the same way as biological females in circumstances she argues are no longer permitted under equality law.

In April 2025 the Supreme Court made a landmark legal ruling that the terms "man" and "woman" referred to biological sex when it came to applying the 2010 Equality Act. Six weeks ago the Equalities and Human Rights Commission (EHRC) published a Code of Practice laying out how this should apply.

The EHRC Code of Practice specifically uses the example of a hospital ward as a place where this code applies. It says allowing trans women to use a service means it could no longer be classed as female-only, and could also be unlawful sex discrimination. Mixed sex wards are no longer allowed in the NHS apart from in limited circumstances.

The current NHS England guidance was originally written in 2019 and states: "Trans people should be accommodated according to their presentation: the way they dress, and the name and pronouns they currently use. This may not always accord with the physical sex appearance of the chest or genitalia".

The website was updated after the Supreme Court ruling in 2025 to say that revised guidance would be published "as soon as possible" but 17 months on hospital trusts still have no national NHS code and are having to formulate their own policies. GMMH follows the existing NHS England guidance.

Dr Michael Foran, an associate professor of law at the University of Oxford and an expert in equality law, said the NHS was struggling to implement the law because of long established practices.

"The NHS has very well-established policies for consulting stakeholder groups in a way that is maximally inclusive," he said

"You can see the NHS is approaching this in the same way that it would approach any new policy. You consult with your stakeholder groups, you get legal advice, you think about how you might best engage this new change."

"But the central problem the NHS is facing is that complying with the law is not a new policy to consult on," he said.

"You don't have a choice as to whether or not you comply with the law."

Dr Foran said the priority was to follow the law and then to work out how to make adjustments so that trans people could properly be cared for.

The EHRC Code of Practice also states that the rights of trans people have to be taken into account when making decisions on single-sex spaces. If they are not properly accommodated then this could amount to discrimination.

But some trans rights groups feel changes to the current guidelines will inevitably lead to a substantially negative impact on trans patients.

Dr A said that she had been raising concerns for years about the trust's policies, including whether biologically male staff members who identify as trans women could provide intimate "same-sex" care to female patients, such as monitoring patients at risk of self harm in the showers or in toilets.

She said that when she raised this theoretical scenario with the trust's Equality, Diversity and Inclusion team she was told that the patient would have to explain why she wanted a biologically female member of staff to provide the care.

"There's a power imbalance there," she said, adding that most female psychiatric patients would struggle to advocate for themselves.

Dr A said that trans people "absolutely deserve respect" and should not be discriminated against, but argued trusts must also comply with equality law.

"We're talking about a law which pertains to the safety and dignity of detained patients."

Dr A's case is an employment dispute. She claims that the trust's repeated failure to respond to her concerns amounts to discrimination against her protected beliefs.

She is being supported by the Christian Legal Centre, which has been involved in a number of cases on this issue.

Andrea Williams, chief executive of its partner organisation Christian Concern, said: "Policies that align with biological reality have to be implemented for the safety and health and protection of everyone who enters the hospital from patient to consultant."

Williams added: "It's baffling as to why the NHS is unable to simply roll this out."

"From Cornwall to Aberdeen NHS trusts are simply not implementing policies which align with the law and it's time for that to change".

Some commentators have suggested that a compromise would be a "third space", such as a private room. But the trans rights group TransActual said this would place trans people in an impossible position.

"If you put trans people in third spaces, we're being ghettoised, we're being segregated away from the rest of society," said the group's director of healthcare, Chay Brown.

He said requiring patients to use separate accommodation could effectively disclose that they were trans and potentially expose them to additional risks.

He added that some people may have transitioned years ago, their friends and neighbours may not be aware of that, and making it public could place them in danger.

Brown added that removing a trans person with a mental health issue from a ward could add to their distress.

"Say someone's going into hospital for reasons that may well have been caused by living in a society that is increasingly marginalising trans people – to be put on a ward that doesn't align with your gender, that is not going to help people get better".

He said that much of the current debate was based on "fearmongering".

"We're the same as anyone. If we're in hospital it's because we need support, whether it's mental health support or physical health."

There is also the question of capacity. Nearly all hospitals already struggle to accommodate patients and any requirement for additional accommodation could create further pressure.

Nevertheless, calls for the NHS to clarify its policies are unlikely to go away. Dr A's case is expected to be heard next year.

A statement from NHS England said: "The NHS will publish approved new guidance for the health service on single sex accommodation shortly, in line with other public sector bodies.

"In the meantime, hospitals should be acting within the principles set out in the Equality and Human Rights Commission code to ensure all patients are cared for with dignity and respect."

Greater Manchester Mental Health NHS Foundation Trust said: "We are committed to providing a safe and inclusive environment for all our patients and colleagues where everyone is treated with dignity and respect, and differing lawful views and beliefs are considered appropriately.

"We are reviewing our policies in light of the updated EHRC Code of Practice and are ensuring our staff have the guidance they need to implement these consistently."

Listen to the best of BBC Radio Manchester on Sounds and follow BBC Manchester on Facebook, X, and Instagram. You can also send story ideas via Whatsapp to 0808 100 2230.