A timeline of single-sex accommodation policy - and its subsequent destruction by stealth
The timeline below sets out key dates for the lobbying of and changes to government policy. The period 2007-2009 appears to be particularly problematic with a lack of official gateway numbers being issued on DfH guidance and significant trans activist lobbying during that period.
Look closely at the irregularities in May 2009 and November 2010 where large policy shifts and reversals are made in letters by Civil Servants apparently acting ultra vires and – if so – this is a major breach of the Civil Service Code.
Also around 2004 the lack of mention of the Gender Recognition Act in the Queen’s Speech. Much has been done to prevent open and democratic discussion of the removal of women’s rights in favour of trans “inclusion”. Many people say that trans inclusion is like gay rights/marriage – but if so why has it not been openly discussed and debated in public?
1997
Labour Manifesto - “As part of our concern to ensure quality, we will work towards the elimination of mixed-sex wards.” This was changed to ‘mixed sex accommodation’ rather than ‘wards’ in 2005.
1998
Health Service Circular 1998/143: “the provision of unisex, single-occupancy toilets and bathrooms can serve as in interim measure until fully segregated facilities are available to meet the Patient’s Charter standard”. Annex C is guidance on definitions in addition to EL(97)3 of 24 Jan 1997. Annex C 1 has exceptions for small group homes, intensive care units and admissions wards. Transgender people are not mentioned.
1998
Trans activist group Press for Change - Briefing Paper - ‘Why “women-only” space must include trans women’.
2000
Home Office - Report of the Interdepartmental Working Group on Transexual People - addressing the problems experienced by transsexual people, ‘having due regard to scientific and societal developments, and measures undertaken in other countries to deal with this issue’. Mention of the GRA text “legal recognition of their acquired gender for all purposes.”
2001
Stonewall launched Diversity Champions programme
2003
26th November 2003 - Queen’s Speech at Opening of Parliament - 18 new Bills listed. No mention of the Gender Recognition Act being brought forward by the government. 27th November 2003 - the very next day after the Queen’s Speech - First Reading of the Gender Recognition Act in House of Lords.
2004
Chief Nursing Officer Bulletin Dec 2003/Jan 2004 - ‘The target to eliminate mixed sex accommodation in 95 per cent of trusts has been met but the NHS has yet to achieve 100 per cent compliance.
2004
1st July 2004 - Gender Recognition Act, Royal Assent.
2004
Department of Health set up Sexual Orientation Advisory Group (SOAG) but changed its name to Sexual Orientation and Gender Advisory Group (SOGIAG) following lobbying from transgender activist group Press for Change.
2006
The Stonewall Workplace Equality Index launched initially in 2005 as the Corporate Equality Index, later changing its name to Workplace Equality Index in 2006. This benchmarking tool aimed to identify and promote leading employers for gay staff by evaluating their policies and practices on workplace inclusion for lesbian, gay, and bisexual (LGB) employees.
2006
The NHS in England: the operating framework for 2007/08. ‘Ensure local implementation of the commitment to reduce mixed sex accommodation, and maximise privacy and dignity in situations where the need to treat and admit.
2007
Department for Health published guidance on Dignity in Care conflates sex and gender - first indication of future attempts to obfuscate conflict of women’s and trans rights.
2007
Department of Health advisory group Sexual Orientation and Gender Advisory Group (SOGIAG) transgender workstream commissioned 9 publications (ranging from guidance for GPs to advice for young people) including “Trans: a practical guide for the NHS”. Many of the publications do not have a Gateway number and are therefore not official Dept for Health publications, however because they use NHS Branding this is unclear. Notably, ‘Transgender experiences: Information and support’ was uploaded to the website on New Years Eve 2007 when it is highly unlikely to have obtained official approval.
2007-2009
28 June 2007 - 5 June 2009 Alan Johnson Health Secretary.
2008
GIRES Publication - Guidance for GPs and other clinicians on the treatment of gender variant people. ‘trans people…should be addressed and accommodated according to the gender in which they present, unless they specify otherwise’. Also acknowledges children are statistically more likely to be gay than trans.
2009
Alan Johnson speech to NHS Chairs Conference on funding and penalities to eliminate mixed sex accommodation. “It is not unreasonable in the 21st century for patients to expect to be treated in single sex accommodation, and not to have to share bathrooms and toilets with the opposite sex.
May 2009
May 2009 - Chief Nursing Officer - Elimination of Mixed Sex Accommodation by Dame Christine Beasley and David Flory. There is no Gateway Number to authorise this as an official DfH publication. For the first time it includes Annex E which sets out a Gender Self ID exemption to the mixed sex accommodation rules. A significant shift compared to the publicly declared policy direction. There is no evidence that this document was given ministerial sign off - note that the date is at the transition between Health Ministers. It may be that this was was published by the Civil Service ultra vires which would be a serious breach of the Civil Service Code.
2009-2010
5 June 2009 - 11 May 2010 Andy Burnham Health Secretary
2010
May 2010 - General Election - Conservative and Liberal Democrat Coalition - David Cameron Prime Minister
2010
October 2010 - The Equality Act comes into effect
November 2010
November 2010 - Chief Nursing Officer - Elimination of Mixed Sex Accommodation. This time with Gateway No. 15024 to confirm it is an authorised publication. Notably Annex E regarding Gender Self ID has been omitted. Instead in Annex B in the schedule of acceptable breaches appears to reverse the 2009 CNO letter. Marked “Never” [acceptable] - it states “May be acceptable, in a clinical emergency, to admit a patient temporarily to a single, ensuite room in the opposite-gender area of a ward. In such cases, a full risk-assessment must be carried out and complete safety, privacy and dignity maintained”. From 1 December 2010, the national collection and monthly reporting of Mixed-Sex Accommodation (MSA) breaches was introduced.
2014
Same-sex marriage is legalised in England and Wales March 2014 and Scotland in December 2014 (Northern Ireland in January 2020).
2015
In January 2015, Nottinghamshire Healthcare NHS Trust was named the UK’s most LGBT-friendly employer by Stonewall, becoming the first NHS organization to top the charity’s Top 100 Employers list. The trust was recognized for its dedication to equality, supporting lesbian, gay, and bisexual staff. In February 2015 - Having achieved their original objectives on gay rights, instead of closing down, Stonewall shifts focus towards trans inclusion with the publication of ‘Trans People and Stonewall’.
2015
May 2015 - General Election - Conservative majority - David Cameron Prime Minister.
2015
Major rise in public and private sector organizations joining the Stonewall Diversity Champions programme from 2015 onwards, often to compete in the “Workplace Equality Index”; income from the schemes rising by 61% between 2014 and 2018.
2017
June 2017 - General Election - Conservative majority - Theresa May Prime Minister.
2017
Significant lobbying for Gender Recognition Reform, designed to make the pathway easier to getting a Gender Recognition Certificate. Prime Minister Theresa May pledged in October 2017 to streamline and “de-medicalise” the process, stating that being trans is “not an illness and it should not be treated as such”.
2018
March 2018 - Gender Representation on Public Boards (Scotland) Act 2018. It set a statutory objective for 50% of non-executive members on Scottish public boards to be women, but included trans identifying males within the category of women on the basis of Gender Self ID.
2019
DfH publish Delivering same-sex accommodation, based on Gender Self ID but no longer hidden away.
2019
December 2019 - General Election - Conservative majority - Boris Johnson Prime Minister.
2019-2021
Under the influence of Stonewall membership schemes (or those of other LGBT charities) NHS Trusts begin re-writing their policies for trans inclusion which allows them to move up the rankings in various diversity schemes. Unfortunately in their desire to reach the “Top 100” the NHS fails to deal with the obvious conflict between trans inclusion via gender self ID and women’s rights. None of the updated policies contain a developed Equalities Impact Assessment.
2020
While Scotland pursued reform, the UK government announced in September 2020 that it would not introduce a Gender “self-identification” process for England and Wales, instead opting to reduce the fee and move the application process online.
2020
Participation in the Stonewall Workplace Equality Index peaked in 2020, with 503 organizations entering—the largest number in the Index’s then-16-year run
2020
For Women Scotland, advocacy group, bring a Judicial Review to challenge the Scottish Government over their inclusion of trans identifying males on the basis of gender self ID into the category of women in the Gender Representation on Public Boards (Scotland) Act 2018.
2021
BBC Podcast “Nolan Investigates - looks at the influence Stonewall has in public institutions across the UK”. Shortly after publication the BBC withdraws from the diversity schemes. And from 2021 following public scrutiny of Stonewall’s methodology and ideological stances, submissions declined sharply; in 2022, only 245 organizations participated, and by 2023, this fell further to around 140
2021
Woman who was raped on a Kent NHS ward by a "trans woman" patient which the hospital denied. Baroness Nicholson of Winterbourne said in 2022 : “They forgot that there was CCTV, nurses and observers. “None the less, it has taken nearly a year for the hospital to agree that there was a male on the ward and, yes, this rape happened". As reported by The Times in March 2022.
2022
A trans identifying female ( a "trans man") was raped by two patients after being booked into Eden Ward at Lambeth Hospital, a secure psychiatric unit, for men with severe mental health problems.
2022
5 September 2022 - 24 October 2022 Liz Truss Prime Minister
2022
24 October 2022 Rishi Sunak Prime Minister
2022-2023
The Gender Recognition Reform (Scotland) Bill was passed in December 2022 to lower the age to 16 and remove the need for a medical diagnosis. This was subsequently blocked by the UK government using a “Section 35 order,” a decision upheld by courts in December 2023
2022
For Women Scotland’s Judicial Review successfully challenges the Scottish Government over their definition of woman in the Gender Representation on Public Boards (Scotland) Act 2018. Scotgov remove the option of Gender self ID and update the Bill to include trans identifying males with a Gender Recognition Certificate in the category of women. FWS bring a further challenge.
2023
Nurse Sandy Peggie was suspended for using the word "man" while trying to explain to her Trans Identifying Male colleague why she didn't want him in the female changing room. An appeal is ongoing but Peggie won her case that NHS Fife had harassed her, but other allegations of discrimination and victimisation were dismissed and Sandie Peggie is bringing an appeal.
2024
Nurse Jennifer Melle was racially abused by a Trans Identifying Male ("trans woman") patient after she referred to him as Mister when speaking to a colleague about his discharge. The patient complained and she was given a warning. When she went to the Press about her experience, she was suspended. In April 2026, Melle reached a settlement ahead of an Employment Tribunal and the Trust said it was "sorry" she had this experience.
2024
July 2024 - General Election - Labour majority - Keir Starmer Prime Minister.
2025
Faye Russell-Caldicott (a pseudonym) filed a legal claim against NHS England, alleging indirect discrimination on the grounds of gender-critical belief, sex, religion and disability (PTSD), due to NHS England's Trans Policy which permitted male colleagues to use female toilets, changing rooms and open plan showers. The hearing was in March 2026 and the judgment is awaited.
2025
April 2025 - For Women Scotland’s case against Scotgov’s inclusion of trans identifying males with a Gender Recognition Certificate in the category of women, within the Gender Representation on Public Boards (Scotland) Act 2018, arrives at the Supreme Court. The Judgment rules against Scotgov and defines the meaning of woman as “biological”.
2026
Eight nurses won their Employment Tribunal against County Durham and Darlington NHS Foundation Trust, for sexual harassment and sex discrimination, because allowing their male colleague Rose Henderson, who identified as a woman, to use the female changing room alongside them and other women was a form of harassment, as it created a hostile environment for the women.