An NHS Trust in the north of England faces legal action from a senior doctor and consultant psychiatrist who alleges that it dismissed serious safeguarding concerns about bearded male patients who identify as women being admitted to female psychiatric wards.
The claimant, anonymised as “Dr A” and represented by the Christian Legal Centre, says vulnerable female patients, including survivors of sexual violence, have been detained in psychiatric wards under unlawful NHS policies which allow mento access these wards and intimate places, such as showers, because they merely identify as women.
On 16 April 2025, the Supreme Court unanimously ruled that “sex”, “woman” and “man” in the Equality Act 2010 refer to biological sex, while confirming that people with the protected characteristic of gender reassignment remain protected from unlawful discrimination.
Dr A expected the Trust to bring its policies into line with the ruling. Instead, she alleges that her repeated requests for clarity were met with delay, resistance and suggestions that the judgment might be challenged in the European Court of Human Rights or conflict with the views of professional bodies, such as the British Medical Association.
The day after the ruling, the Trust reportedly told staff there would be no immediate changes for patients.
Dr A believes sex is biological, binary and immutable, and that female patients and staff are legally and morally entitled to single-sex wards, toilets and changing facilities. Her case argues that these beliefs are protected under the Equality Act and that she suffered workplace detriments for expressing them.
As of 12 August 2026, the Trust’s Delivering Single Sex Accommodation policy continued to state that trans patients should be accommodated according to their presentation, including for toilet and bathing facilities.
Last updated in October 2023, the policy states that “trans people should be accommodated according to their presentation (the way they dress, the name and pronouns that they currently use)”.
It goes further by stating “this applies to toilet and bathing facilities”. Regarding non-binary individuals, “who do not identify as being make or female, should also be asked discreetly about their preferences, and allocated to the male or female ward according to the choice”.
Dr A is also concerned about the recording of sexual safety incidents. She alleges that the Trust’s Sexual Safety Policy could result in an assault by a biological man who identifies as a woman being recorded as female-on-female violence, preventing accurate monitoring and scrutiny.
In January 2026, she submitted a Freedom of Information request about opposite-sex admissions to a local adult inpatient unit. The Trust said its records captured self-stated gender and that incomplete birth-sex data meant answering the request would require a costly audit. Dr A argues this shows the Trust cannot readily identify or monitor opposite-sex admissions.
The Trust’s local Integrated Care Board reportedly advised shortly after the Supreme Court judgment that spaces designated as single-sex were solely for people of that sex and urged the Trust to reflect this in its policies.
Dr A has also cited the Workplace Regulations 1992, which require separate toilets, changing and washing facilities for men and women unless lockable single-occupancy rooms are provided.
However, the Trust’s Transitioning at Work policy states that staff who identify as trans are entitled to use facilities corresponding with their gender identity.
In May 2025, Dr A said she was reluctant to use the women’s toilets at the Trust’s headquarters because male staff who identify as women were permitted to use them. A senior colleague offered to accompany her to the toilets and to guard the entrance to the toilets when she was in there. Dr A rejected the offer as offensive and humiliating and was advised to use gender-neutral toilets instead.
Her legal claim alleges that, 16 months after the Supreme Court ruling, the Trust had neither amended its key policies nor stopped admitting biologically male patients to female psychiatric wards.
She says its response to her concerns was unnecessarily prolonged and distressing, and amounted to unlawful discrimination because of her protected beliefs.
Concerns for vulnerable female patients
Dr A raised said she had raised concerns long before the Supreme Court’s ruling in 2025.
She says she repeatedly raised the issue through internal channels, including discussions around Equality, Diversity and Inclusion (EDI) training, which she believed created confusion among staff about the distinction between sex and gender.
Dr A felt increasingly isolated and found that colleagues felt scared to raise the issues and did not understand her concerns about the need to protect vulnerable women and girls. Dr A was surprised by the lack of urgency especially since most psychiatric inpatients are detained under the Mental Health Act 1983 and are, therefore, not free to leave.
Dr A argues that women receiving inpatient psychiatric treatment are among the most vulnerable patients in the healthcare system.
Dr A was also concerned that biologically male staff members, who identify as women, could be put forward to provide intimate same sex care to female patients, if they hadn’t already.
For example, a female patient who was deemed to be a risk to herself would likely be supervised in the shower whilst using a razor to shave her legs.
When Dr A raised this scenario with the EDI team , she was told that the female inpatient would have to justify why she wanted same sex intimate care, for example citing a history of sexual abuse, and the nurse in charge would have to decide if her argument was good enough.
During this conversation, Dr A was also told that there were no plans for this scenario to be addressed in any policy. Dr A alleges that her concerns around legitimate same sex care were dismissed as being hypothetical and not worthy of further institutional consideration.
In January 2024, via email, Dr A made a formal complaint to the Trust’s then Head of EDI about its “factually incorrect and misleading” mandatory Equality, Diversity and Human Rights training but Dr A never received a response even though she chased it up via email six weeks later.
Following a Subject Access Request, the Trust later confirmed that the Head of EDI had received her emails.
Grievance and alleged failure to act
Since 2023, Dr A has raised concerns that the Trust’s policies compromised the safety, dignity and privacy of female patients and staff. She raised these concerns with the EDI team and, following the Supreme Court ruling in 2025, senior Trust executives.
In June 2025, she lodged a formal grievance over the Trust’s alleged failure to implement the ruling. She claims the process was delayed and procedurally flawed.
The Trust partially upheld her grievance in autumn 2025. The panel recommended reviewing relevant policies and training, setting indicative timescales, clarifying the distinction between “sex” and “gender”, communicating about single-sex facilities and reviewing the Transitioning at Work Policy.
Dr A appealed. Although the Trust largely dismissed her appeal earlier this year, it agreed to several actions, including a Trust-wide statement on facilities, explanatory notes for relevant policies and training, progress updates and clearer information about toilet provision. It declined to set firm deadlines for the wider policy review.
The Trust has since clarified the meaning of sex in mandatory EDI training, removed several optional training modules and added information about the Supreme Court ruling to its intranet. However, Dr A alleges that, by 6 August 2026, most of the agreed actions remained outstanding.
She says no Trust-wide statement has been issued and no key policy revised.
Her claim alleges a failure to recognise sex-based rights under the Equality Act 2010 and an ideological commitment to contested beliefs about gender identity.
She also cites the Trust’s policy encouraging preferred pronouns in email signatures and immediate apologies for incorrect pronoun use.
Protected beliefs and freedom to speak out
From the beginning, Dr A believes she has had a professional and moral duty to advocate for vulnerable patients and colleagues.
She alleges that the Trust’s policies, handling of her grievance and appeal, and failure to implement agreed actions amounted to harassment, direct or indirect discrimination because of her gender-critical beliefs and their expression, creating a hostile and humiliating environment.
She asks the Employment Tribunal to determine whether this formed an ongoing course of unlawful conduct and seeks compensation and other relief under the Equality Act 2010, including a recommendation that the Trust reserve female toilets for biological women.
“I could not remain silent”
Dr A said:
“I felt increasingly alone in raising these concerns. I was repeatedly told the issue required nuance, and case by case consideration, but what seemed to be missing was a willingness to acknowledge the reality that many women are deeply distressed by the presence of men in women-only spaces, especially on hospital wards.
“The public, politicians and the media need to know that mentally ill men and women are being detained together on mixed sex wards whilst the NHS pretends its wards are single sex.
“After the Supreme Court judgment, I expected policies and practices to change quickly. Instead, I encountered continued uncertainty, reluctance to provide clear answers, and what I believed was an institutional failure to recognise the importance of genuine single-sex spaces for vulnerable women”.
“Female psychiatric patients are among the most vulnerable people in our healthcare system. They are detained in these wards, many have experienced violence, abuse or trauma. They may be frightened, heavily medicated or simply unable to speak up when they feel unsafe.
“As a senior doctor, I could not remain silent while women’s privacy and dignity were being compromised. I raised these concerns because I believe every patient has a right to be treated with compassion and to have her sex recognised when intimate care, accommodation and personal safety are involved.
“I also felt a responsibility to junior female colleagues who may not have believed they could object. Senior clinicians should be able to raise serious safeguarding concerns without being marginalised or treated unfairly.
“The Supreme Court provided clarity about the meaning of sex in the Equality Act. I expected the Trust to review its policies promptly and communicate clearly with staff. Instead, many of the recommendations and agreed action points remained outstanding when my claim was filed.
“Bringing legal proceedings is not something I have undertaken lightly. I am doing so because female patients and healthcare professionals deserve so much better. Lawful policies must be brought in urgently and the government must act.”
Christian Legal Centre support
Andrea Williams, chief executive of the Christian Legal Centre, said:
“This case exposes the profound consequences that arise when an NHS Trust loses sight of biological reality.
“Women admitted to psychiatric hospitals are often at a point of extreme vulnerability. Some will have experienced sexual violence, domestic abuse or other serious trauma. Their need for privacy, dignity and safety cannot simply be set aside.
“It beggars belief that, in precisely the kind of environment where safeguarding should come first, biological sex can effectively be disregarded and a biologically male staff member or patient are treated as a woman for access to female-only spaces.
“Dr A acted with courage, professionalism and compassion. As a consultant psychiatrist, she sought to protect patients and support colleagues who might not have felt able to raise these concerns themselves.
She says the Trust then failed to implement recommendations and action points arising from its own grievance process.
“The Supreme Court has confirmed that sex in the Equality Act means biological sex. NHS bodies cannot behave as though that judgment does not exist. Nor should doctors be penalised for asking their employers to recognise the law and protect single-sex spaces.
“This case is about freedom of belief and the dignity of women in the most sensitive clinical environments. We stand with Dr A as she seeks justice.”