BARONESS NICHOLSON: Why I fear the sanctity of single sex wards is under threat from trans rights

A hospital should be a refuge — somewhere that ill and vulnerable people can stay in absolute safety, their only concern being to focus on getting better.

But, sadly, I have come to learn these institutions can at times stray far from this ideal.

For well over a year now, people working across the NHS have been writing to me to tell of their deep concerns about a tragic and, I believe, dangerous shift that has taken place inside our hospitals.

The consequences of this change were foreseeable — but are no less horrifying.

In my capacity as Chair of the parliamentary campaign group Children and Women First, I have been reading of the most appalling sexual behaviour alleged by whistleblowers to have taken place on hospital premises, including at least one case of rape. 

Though the accounts are unproven at this stage, they are serious enough to be highly worrying.

A hospital should be a refuge – somewhere that ill and vulnerable people can stay in absolute safety, their only concern being to focus on getting better (stock image of hospital)

And what has made this possible?

Without consultation — and in my opinion, in defiance of the law — NHS Trusts across the country have issued guidance saying patients should be accommodated based on the gender they say they identify with. 

This means they can pick which ward, toilets and shower facilities they use.

As a result, a biological male who is ‘physically intact’ — that is, who possesses a penis — has the right to choose to be accommodated on a female ward and to use women’s lavatories and facilities.

Many biologically female patients have understandably been left distraught, forced to share some of their most intimate and vulnerable moments alongside a member of the opposite sex.

Others, like those in the ward disturbed by their presence, have been left uncomfortable to a degree. 

Still others, as my correspondents from across the NHS have said, are alleged to have seen or experienced far worse.

Yet, often, they object at their peril. Many of those who have expressed discomfort at this turn of events — be they patients or nursing staff — have been accused of transphobia and hate crime. Some nurses have lost their jobs.

In my capacity as Chair of Children and Women First, I have been reading of sexual behaviour alleged by whistleblowers to have taken place at hospitals. Pictured: Baroness Nicholson

Hard to believe, isn’t it?

Hospitals are exempt from the Equalities Act of 2010, which outlawed discrimination or unfair treatment on the basis of certain personal characteristics, among them age, religion or sexual orientation. 

It means they were one of the few places where you can — or could — insist on the privacy of a single-sex space.

Moreover, that right had been hard-won in only recent history. While single-sex wards were standard practice for decades, in the late-1970s and early-1980s the NHS started to move towards mixed-sex wards to cut nursing costs and make the best use of diminishing numbers of staff.

It led to widespread complaints, particularly from female patients worried about being in beds alongside male patients, and sharing washing facilities with them. 

It took years of lobbying from health professionals and organisations — among them the Mail — for the law to change.

That happened in 2011, when a redrafted version of the Patient’s Charter announced mixed-sex hospital wards were to be phased out, with patients given the right to request a bed on a single-sex ward.

Separate lavatories also had to be provided on existing mixed-sex wards. Since April that year, Trusts have been fined £250 when a patient is placed on a mixed-sex ward.

Of course, there are exceptions. There are clinical circumstances where mixed-sex accommodation can be justified, for example, patients who need specialised care, such as in critical care units.

And, let me be clear, no one would want to deny the rights of a vulnerable trans person to be accorded the respect of hospital accommodation that best caters to their needs, both emotional and physical.

Without consultation, NHS Trusts across the country have issued guidance saying patients should be accommodated based on the gender they say they identify with (stock image)

I appreciate there are no easy answers, as there rarely are when it comes to overlapping rights. But it must be discussed openly, not in secret.

Sadly, what is happening in wards up and down the country is that that very basic respect for a patient’s rights is being overturned.

In September 2019, NHS England and NHS Improvement published a revised version of their guidance. 

They advised patients should be accommodated according to their presentation: the way they dress, and the name and pronouns they use. 

This has formed the basis of a change of policy in a number of NHS Trusts, some of whom concluded this right should be extended to male-born sex offenders, telling staff that while a criminal history should be part of a ‘risk assessment’ it is not a bar to admission.

Leaving aside the momentousness of that statement, the fundamental point is that this has been done without discussion. 

In their haste to assert the primacy of ‘Self-Identification’ — in which a person can legally declare their own gender regardless of their biology — NHS chiefs have knowingly distorted the equality laws that Parliament has passed and the Queen herself has signed.

And it is women who are paying the price. As a woman who has spent a great deal of her adult career campaigning for the rights of women and children, I approached colleagues to form an all-party campaign group to collect evidence from patients and medics on the impact of the deviation from single-sex spaces.

The examples we have received are legion. 

In hundreds of emails and hours of personal testimony, we have heard cases ranging from dementia patients distressed at waking up next to someone who, in their mind, looks like a man, to reports of a rape on a psychiatric unit undertaken by a biological male who identified as a woman. 

I urged the Government to suspend the NHS guidelines which are at the root of the policies. Health Secretary Sajid Javid (pictured) said he had ‘asked [the Department] for advice’

I recently urged the Government to suspend the NHS guidelines which are, to my mind, at the root of policies of NHS Trusts nationwide.

And last night, Health Secretary Sajid Javid tweeted: ‘It’s not wrong to look at whether guidance is right, or how it’s being applied, to reassure everyone… I’ve asked [the Department] for advice.’

It is time he did so, whatever the furore it may provoke.

I am in no doubt my forays into the whirlpool of transgender issues leave me open to abuse. I refuse to be cowed by it: it hasn’t worried me in the past, just as sticking my head above the parapet now doesn’t worry me.

When you speak up for what is right there will always be those who endure cancellations from much-loved institutions; it doesn’t matter.

What does matter is that we find a way of protecting the vulnerable.

In my work around the globe, I have always cited the country of my birth as a shining example of a nation which upholds the rights of women, and our NHS as a beacon of health care provision.

However, the scandal that is unfolding in our single-sex wards has led me to conclude that neither of these proclamations remains true.

Baroness Nicholson is Chair of the Parliamentary campaign group Children and Women First.

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