An NHS trust has updated its policy on single-sex spaces in light of last year’s Supreme Court ruling on the meaning of ‘sex’ — in defiance of the judges. West London NHS Trust has said it will allow patients to use single-sex facilities based on their “legal gender”, a concept specifically rejected by the court.

It’s clear from the Court’s judgment that trans-identified men with a gender recognition certificate are legally male, and have no more right to use single-sex facilities intended for women than other men. But it seems they will be permitted to do so in establishments run by the trust, regardless of how women feel about it.

If other trusts follow suit, it will be an indictment of ministers’ inaction. Wes Streeting made sympathetic noises about the issue when he was Health Secretary, meeting the Darlington nurses who were awarded £187,000 in compensation last week after being told to share facilities with a trans-identified male.

But Streeting didn’t follow through by telling NHS trusts to follow the law, and the chances of his successor, James Murray, showing more guts are vanishingly small. Murray claims to have changed his mind about gender ideology, saying shortly after he was appointed that he no longer believes that trans women are women. But last week he voted in the House of Commons to allow a controversial puberty blockers trial on children as young as 10 to go ahead.

NHS trusts up and down the country have got the message: despite the ruling, it’s business as usual for captured organizations, while female staff and patients who don’t want men in single-sex spaces will be forced to contemplate going to court.

No one should ever underestimate the degree to which gender ideology has infiltrated the NHS. Hospitals in west London are a warning of how easily trusts gave in. West London NHS Trust has a history of currying favor with trans organizations, boasting in 2023 that it had won Stonewall’s bronze award for “leading LGBTQ+ inclusive employers”. It regretted that it hadn’t made Stonewall’s list of top 100 employers that year, but said it had “undertaken significant strides towards creating an inclusive working environment”.

The trust is based mainly in Acton, Brentford and Ealing, and shares some facilities at Charing Cross Hospital in Hammersmith, where it offers mental health services. The hospital is administered by a neighboring organization, Imperial College Healthcare Trust, which stopped offering “feminizing” surgery in 2021. However, patients arriving for X-rays or to visit sick relatives in 2022 still had to walk along a corridor bearing the message: “If I hadn’t transitioned, I wouldn’t be myself or even alive.”

It should have been obvious to the Government last year, following the judgment, that NHS leaders who had allowed such nonsense to proliferate would not give up without a fight. But trusts haven’t even needed to do that. When there’s a conflict between the rights of the female half of the population and a species of magical thinking, they know which side ministers are on.

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Joan Smith is a novelist and columnist. She was previously Chair of the Mayor of London’s Violence Against Women and Girls Board, and is on the advisory group for Sex Matters. Her book Unfortunately, She Was A Nymphomaniac: A New History of Rome’s Imperial Women was published in November 2024.

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