West London NHS Trust has updated its single-sex spaces policy in the National Health Service to let patients use facilities based on their “legal gender” after last year’s Supreme Court ruling on the meaning of “sex”. The policy puts the trust at odds with a ruling the article says rejected “legal gender” as a basis for single-sex access.
Joan Smith, the novelist and columnist who wrote the piece, said she had been Chair of the Mayor of London’s Violence Against Women and Girls Board. She said the trust’s approach could leave female staff and patients who do not want men in single-sex spaces with court action as their main route to challenge it.
West London NHS Trust policy
The trust said it will allow patients to use single-sex facilities according to their “legal gender”, and the article describes that as a change made in light of the Supreme Court ruling. West London NHS Trust is based mainly in Acton, Brentford and Ealing, and it shares some facilities at Charing Cross Hospital in Hammersmith.
The new wording matters because it translates a legal argument into day-to-day access rules inside wards and departments. Under the trust’s approach, the deciding factor is the gender recorded as legal status, not biological sex, even though the article says the Supreme Court specifically rejected that concept.
Joan Smith and the dispute
Smith places the trust’s policy against earlier positions it took in public. In 2023, West London NHS Trust said it had won Stonewall’s bronze award for “leading LGBTQ+ inclusive employers”, regretted not making Stonewall’s list of top 100 employers in 2023, and said it had “undertaken significant strides towards creating an inclusive working environment”.
The piece also links the issue to other National Health Service disputes. Wes Streeting met the Darlington nurses who were awarded £187,000 in compensation last week after being told to share facilities with a trans-identified male, and James Murray voted in the House of Commons last week to allow a controversial puberty blockers trial on children as young as 10 to go ahead.
Supreme Court ruling and NHS
The trust’s decision sits inside a wider dispute over how NHS organisations respond to the Supreme Court ruling on sex and single-sex spaces. The article says ministers have not given NHS trusts a clear instruction to follow the law as the writer sees it, and it raises the possibility that other trusts could copy West London NHS Trust’s approach.
That leaves a practical choice for affected patients and staff at the trust’s west London sites: accept the policy as written, or challenge it through the courts. If other NHS trusts adopt the same rule, the dispute will move from one trust’s policy page into a broader test of how the National Health Service applies single-sex access after the ruling.
