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Hospital Spaces in NHS England must now be assigned by 'biological sex'

Started by Tills, October 15, 2026, 11:46:02 AM

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Stottie Girl

Exactly this Susan (I am impressed at your understanding of UK law!). This is what I am referring to in my post. The Supreme Court interpreted the wording of the act but the acts themselves are created by the politicians in parliment. It only needs the wording to be changed by an act of parliment and the whole problem goes away. As I said though, there is no political will to do it right now or at least not enough of it. It is not a vote winner and there is currently no financial incentive to do it.

I believe this will change when the legal discrimination cases start mounting up but this will take time. The UK court systems have years long backlogs so even if someone raised a case now it might not reach court for 2-3 years or more.

As I said, a total mess. If Reform get into power there will be zero chance of anything happening, they are capable of making things far far worse in fact. It does seem that their popularity is beginning to slide a little as more people realie what they actually stand for.
A wise man once said don't judge a man until you've walked a mile in his shoes, that way when you judge him you're a mile away and you have his shoes!

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Sarah B ✅

Hi Tills

I agree that "biological sex" is complex and that chromosomes, hormones, gonads, anatomy and other traits can vary.  Intersex variations are real too.

Where I disagree is with your description of my argument as "narrowly conceived" and "reductionist".

The real disagreement here is with the definitions themselves.  The definitions I quoted were not my own.  They came from the NIH, the Endocrine Society and the National Academies and I used them as the baseline for what biological sex means.

I also did not reduce "biological sex" to one characteristic.  I specifically referred to chromosomes, gonads, hormones and reproductive anatomy.  That was also the point I was making in my reply to Kathy.  A field biologist may identify an animal as male or female by looking at visible anatomy because those characteristics are normally reliable indicators of sex.  But that does not mean "biological sex" is defined as whatever can be seen through binoculars.

External anatomy is evidence of biological sex.  It is not the definition of "biological sex".  If visible anatomy can reasonably be used to identify the sex of other mammals then it makes little sense to say that the same kind of evidence has no relevance when identifying sex in humans.

So when you say, "You have taken one set of biological markers and excluded so many others" and "You cannot separate out one part of the bodily function from others and say, in true reductionist fashion, that this is the defining characteristic", that is not the argument I made.  That is a straw man fallacy.

It seems that what you are really arguing is that the definitions themselves are too narrow because they do not include all the additional biological traits you listed.  That is a different argument or framework.

Perhaps it would help if you gave the definition of "biological sex" that you are using here.  You have explained why you consider the definitions I quoted too narrow and listed a number of additional biological traits that you believe should be included, but I am still not clear on what your alternative definition of "biological sex" actually is.

I have looked at the papers you added.  They support things I have never disputed: there are many biological differences between males and females and gender incongruence may have a biological basis.  Some of the papers look at chromosomes, hormones, receptors, genetics and brain differences.  The brain research is just one example of the extra traits you are trying to bring into the definition of "biological sex".

Some studies have found differences in transgender people that resemble patterns more commonly found in the opposite sex but the findings are mixed and many of the studies are based on small samples.  None of this shows that these additional traits should become part of the definition of "biological sex".

The number of citations presented risks becoming citation dumping.  A large volume of citations does not show that the definitions of "biological sex" are wrong.  What matters is whether those studies actually support the conclusion that these additional traits should be included in the definition of "biological sex".

Something being biological or associated with sex does not automatically make it part of the definition of "biological sex".  Hormone levels, receptors and other traits can vary within males and females.  That does not mean every biological difference becomes a separate way of deciding whether someone is male or female.

The same applies to brain differences and gender incongruence.  Even if gender identity has biological influences that does not make gender identity itself a "biological sex" characteristic.  The same applies to intersex variations.  They show that sex development can sometimes be atypical.  They do not make the baseline definitions invalid or show that the distinction between male and female disappears.  Likewise, having a chromosome variation does not by itself show that someone was wrongly identified as male or female at birth.  That depends on the particular variation and what effect it had.

Saying that my response is "part of the problem" goes beyond disagreeing with the definitions or with my reasoning.  I was using established definitions and explaining the distinctions they make.

In your final reply you describe my position as "narrowly conceived and reductionist".  But I did not create the definitions I used.  I quoted definitions from the NIH, the Endocrine Society and the National Academies and used them as the baseline for what "biological sex" means.  So I do not see how relying on those definitions makes my position narrowly conceived or reductionist.  If you believe those definitions are too narrow then you need to show why they are wrong or inadequate.  So far you have shown that biology is complex but you have not shown that the definitions themselves are wrong.

You are right that this is a supportive space, but this is also a site where people learn from one another, share what they know and share their experiences.

I have no interest either in turning this into an endless argument.  So I am happy to leave it there and accept that we disagree.

Best Wishes Always
Sarah B
Global Moderator
@Tills
Be who you want to be.
Sarah's Story
Feb 1989 Living my life as Sarah.
Feb 1989 Legally changed my name.
Mar 1989 Started hormones.
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Sarah B ✅

Hi Susan

A brilliant post if I ever saw one.  Sometimes one does not see the forest for the trees.  I agree that the laws need to change.

Best Wishes Always
Sarah B
Global Moderator
@Susan @Stottie Girl
Be who you want to be.
Sarah's Story
Feb 1989 Living my life as Sarah.
Feb 1989 Legally changed my name.
Mar 1989 Started hormones.
May 1990 Three surgery letters.
Feb 1991 Surgery.

Petunia

Both Susan B and Sarah have said what I have no hope of expressing.

And then one day you stop to find,
10 years have got behind you,
no one told you when to run,
you missed the starting gun
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Tills

Quote from: Sarah B on October 16, 2026, 06:04:05 PMHi Tills

External anatomy is evidence of biological sex. 


It seems that what you are really arguing is that the definitions themselves are too narrow

Perhaps it would help if you gave the definition of "biological sex" ...  I am still not clear on what your alternative definition of "biological sex" actually is.

The number of citations presented risks becoming citation dumping.  A large volume of citations does not show that the definitions of "biological sex" are wrong. 


Best Wishes Always
Sarah B
Global Moderator
@Tills

Hi Sarah,

The peer-reviewed scientific papers I cited were there to illustrate to you, and others, that there is no firm definition of the term 'biological sex'. Scientists, including biologists, neurologists, and endocrinologists have shown that the term is narrowly conceived - which is what I suggested you repeated.

So, no, I will not provide you with an alternative definition of 'biological sex'. The term is utterly meaningless, devoid of sound scientific basis, and should play no part in this or any other discussion. Like most binary thinking it's simplistic and reductionist.

Labels like this are use to categorise, to box and confine, to subjugate. Edward Said brilliantly demonstrated how this happens in his 1978 book Orientalism and the same is happening here with 'trans' people. Those who seek to have control over others categorise complex biology into simplistic binary categories: you are either this or you are that. But life on earth is rarely, if ever, so simplistic. The nuances and complexities, the variations and mutations, the adaptations and transformations, make a nonsense of such reductionist binary definitions. Which is what those peer-reviewed scientific papers neatly illustrate: they are science's 'yes but ...'. They are Dr Malcolm's immortal 'but...'. I could have added a hundred more.

I hate the word 'trans' and don't use it of myself (for similar reasons to the above) but the trans community never should have ceded this false distinction between sex and gender. By splitting the two, trans exclusionists have been able to drive the media argument that biological sex is immutable whereas gender is acquired, and therefore misguided. But of course you cannot have gender incongruence without roots in biology or so-called 'biological sex'. We who have been medically, scientifically, diagnosed this way are part of the complexity and nuance of 'biological sex' as are so many other variants and adaptations.

It's at best a limited term with flaws, but the general public has latched onto it without understanding those limitations, and it has been weaponised by trans exclusionists and politicians.

xx

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Tills

@Susan 's post is indeed brilliant, and so is @Stottie Girl 's follow up.

However, sadly, I have zero faith that the UK or at least England, will reverse this ruling or the ruling behind the ruling. I doubt whether there will be any successful legal challenges because behind it lies the ruling of the Supreme Court (sounds like something out of the worst of the Sith) which appears to have superseded all other protected rights of 'trans' people, including those of the Equality Act of 2010. I think we're kidding ourselves to think otherwise. That's the sad reality of the UK now.

This latest ruling should be understood in the context of a trajectory that the UK embarked on some years ago and our community is not the only one swept along by the torrent.

xx
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Stottie Girl

I have been looking further into this issue as I may fall foul of it next year. I have an appointment with a surgical team in January which might result in me having my gall bladder removed. Whilst it is often done as a day patient it can also involve a stay in hospital where these rules might affect me.

Anyway, delving deeper into the subject it appears that presenting transwomen will have to be placed in side rooms based on clinical needs. These include psychological safety, freedom from severe distress, and personal dignity. Thus meaning that they cannot put you on a male ward for those reasons as well as it creating major safeguarding issues for the nursing staff and could result in patients refusing care or walking out. Hospitals are acutely aware that forcing an unsafe placement that leads to a patient walking out creates enormous legal and clinical liability for the NHS Trust. Doctors and hospitals hate being liable for anything!

So my gut feeling is that for routine operations and general admisions the trusts will be booking us into side rooms (which personally I prefer as they are usually en-suite). It may be different for emergency stuff but then you probably won't care in that event and I'm not sure emergency care wards are segregated by sex anyway?

Whether this causes longer wait times for trans patients waiting for side room bookings remains to be seen but I highly doubt that the headlines of putting a trans patient onto a ward that aligns with their birth sex will actually happen in reality.

I also looked into intersex conditions and if you are diagnosed with an intersex condition of any kind then you will automatically always be put into side rooms. You cannot go into either sex wards. That may be beneficial to you, it may not.

For me, whilst I do not like being treated separately to CIS women, I do not mind being placed in a side room. I personally view it as an upgrade! I am sure the more militant among you will be more angry about this but I am a little bit more relaxed about this rule now.
A wise man once said don't judge a man until you've walked a mile in his shoes, that way when you judge him you're a mile away and you have his shoes!

Never trust a man who, when left alone in a room with a tea cozy, doesn't try it on - Billy Connolley
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Finally Anna

All of my experience with healthcare here says that the people in there are very professional, care a lot about their patients and will often go that extra mile to make things be good. This is probably true also in the UK?
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Out to self since March 5, 2026. My wife knows it all since June 23.
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KathyLauren

The only time I have stayed in hospital, I was assigned to a mixed room, when I wasn't in ICU.  It wasn't that big a deal.  The doctors and nurses would draw the curtains when doing something that might infringe upon my privacy.  They gave each of us a spare hospital gown that we could put on backwards for going to the bathroom, so we weren't exposing our bare butts.

It wasn't rocket science.  It worked.  No reason it couldn't work in the UK, too.
2015-07-04 Awakening; 2015-11-15 Out to self; 2016-06-22 Out to wife; 2016-10-27 First time presenting in public; 2017-01-20 Started HRT!!; 2017-04-20 Out publicly; 2017-07-10 Legal name change; 2019-02-15 Approval for GRS; 2019-08-02 Official gender change; 2020-03-11 GRS; 2020-09-17 New birth certificate

Tills

Quote from: KathyLauren on October 17, 2026, 10:01:29 AMThe only time I have stayed in hospital, I was assigned to a mixed room, when I wasn't in ICU.  It wasn't that big a deal.  The doctors and nurses would draw the curtains when doing something that might infringe upon my privacy.  They gave each of us a spare hospital gown that we could put on backwards for going to the bathroom, so we weren't exposing our bare butts.

It wasn't rocket science.  It worked.  No reason it couldn't work in the UK, too.

Agreed. But in NHS England it's no longer permitted to have mixed sleeping wards, the only exception being emergency treatment areas.

The idea that a 'transwoman' would get a side room or some sort of special placement is, I fear, wishful thinking. Side rooms, such as they exist, are reserved for highly infectious or acute patients. Kicking up a fuss about it won't help much either. Any attendance in A&E will reveal just how many patients get irate and lose their rag with staff (who aren't to blame).

There's a clear direction of travel in the UK and it's not trans supportive.

xx
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