16/10/2026
Sparkle Initial Statement: NHS England's Privacy, dignity and safety in hospital accommodation
Everyone deserves to receive healthcare in an environment where they feel safe, respected and treated with dignity. We recognise that NHS England’s updated guidance on single-s*x spaces raises important questions about how these principles can best be upheld for all patients.
The updated guidance states “trans people and others with the protected characteristic of gender reassignment should be accommodated in line with their biological s*x” the EHRC defines biological s*x as s*x assigned at birth.
For many trans people, being placed on a ward that does not align with their gender identity can be distressing, expose deeply personal information about their trans status, and increase their vulnerability to harassment, discrimination and abuse. We are concerned that a policy which prioritises biological s*x without sufficient clarity around individual circumstances and safeguards risks undermining the very dignity, respect and safety it claims to protect.
The guidance later states “In instances where it would not be clinically appropriate to deliver care to a trans patient on a ward or bay that aligns with their biological s*x, providers should identify alternative arrangements.”
While recognising that individual circumstances may vary, this statement raises significant questions about how the guidance will be implemented in practice. What constitutes a situation in which accommodation in line with a patient’s biological s*x is not clinically appropriate, and who will make that determination? What criteria will be used, and how will the patient’s own views, needs and safety be taken into account?
We need clarity about what these alternative arrangements will actually look like.
We are already aware that the trans community avoids seeking medical care due to fear of discrimination. According to TransActual’s Trans Lives 2025 Report, 64% of trans people avoid visiting their GP and 37% avoid going to A&E. We are concerned that the new guidance will create further barriers for trans, non binary and gender diverse people accessing care.
We believe privacy, dignity and safety must apply to every patient, including trans people. These principles should be upheld in practice, not simply stated in policy. All trans people deserve NHS care that is compassionate, respectful and safe.
We would urge the community to continue to seek healthcare should they need it. And please reach out support if you need it.
