An investigation has found that several NHS mental health hospitals, including high-security facilities that treat violent offenders, are placing biologically male patients on female-only wards if they self-identify as women.
The review, based on policies obtained from London’s mental health trusts through freedom of information requests, revealed that transgender individuals are being placed in single-sex spaces according to their gender identity. The findings were first reported by The Times.
The audit included institutions like Broadmoor Hospital, which holds forensic patients—people detained for mental health treatment instead of prison, often due to violent offenses.
Women’s rights campaigners have raised serious concerns, warning that the NHS is endangering female patients by allowing these placements. “NHS trusts are playing Russian roulette with women’s safety,” said one activist involved in the audit.
Policies Allow Gender Identity to Override Birth Sex
The trusts’ policies show that biological males who identify as women can be placed in female spaces, even when hospitals acknowledge that some transgender patients could pose risks. These risks include being “sexually disinhibited” or causing distress to other patients on single-sex wards.
South West London and St George’s Mental Health NHS Trust, for example, noted that male transgender patients might be temporarily housed in wards matching their birth sex while they are “acutely unwell.” Once their condition stabilizes, the trust stated, it would reassess the risks and consider moving them to a ward aligning with their gender identity.
The trust described a case where a transgender patient undressed in front of the opposite sex and exposed their genitals. Its policy explained that depending on where the patient is in their transition, placing them in a ward matching their biological sex may prevent them from “outing” themselves in distressing or inappropriate ways.
Other Trusts Support Self-Identification Policy
The Central and North West London NHS Foundation Trust said it supports a person’s right to self-identify as male or female. It allows trans women to access women’s support groups and bathrooms but also noted that “further consideration” might be needed in some cases—especially when patients pose a risk of disturbing others.
“A sexually disinhibited pre-operative transsexual individual may be very distressing for other patients on a single-sex ward,” the trust stated.
Similarly, West London NHS Trust—which manages Broadmoor, a high-security hospital that once housed serial killer Peter Sutcliffe—stated that staff must respect patients’ chosen names, titles, and ward accommodations.
Supreme Court Ruling Sparks Policy Review
The NHS is now reviewing its policies in response to a recent Supreme Court ruling, which clarified that under equality law, a woman is defined by biological sex. Current NHS guidance, published in 2019, says that transgender patients should be placed based on their gender identity.
“This ruling makes it clear that single-sex spaces must be based on biological sex,” said one campaigner. “It’s frightening to think that people with violent histories could be placed in women’s wards based solely on gender identity.”
Helen Joyce, advocacy director at the women’s rights group Sex Matters, said the current policies put vulnerable women in danger. “The Supreme Court was crystal clear. No male patient should ever be allowed in female accommodation under any circumstances.”
She criticized the “case-by-case” approach some trusts take, calling it inadequate and dangerous.
NHS Response: Awaiting Further Guidance
A spokesperson for the NHS said that the organization is reviewing the implications of the Supreme Court ruling and will update its guidance accordingly. The spokesperson added that the NHS is waiting for statutory guidance from the Equality and Human Rights Commission before finalizing any policy changes.
“In the meantime, we’re working closely with the government to ensure new guidance is ready for the health service as soon as possible,” the spokesperson said.
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