It is with great dismay that I once again see the targeted discourse around the rights of transgender people in health and public spaces as part of the NHS Constitution Review. It was not so long ago that I was compelled to make a statement regarding the words of the previous Health Secretary and it appears that despite a change of office, the same position still stands. As such, so do my original sentiments.

In short, the NHS Constitution review’s potential to affect the Single Sex Accommodation Policy is of serious concern. The current policy functions well and I am disappointed to see the change of stance within the NHS. From our positive conversations in 2021 about making the language more inclusive, we are now standing at the precipice of a blanket exclusion of transgender people from the ward aligned to their gender.

The current policy includes recommendations for the placement of trans persons on wards aligned to their gender or the provision of a separate side room where deemed appropriate, to be assessed on a case by case basis. This approach is in line with the 2019 position of the Equality and Human Rights Commission.

So, why the need for the policy revision, and why now? In my opinion, the burden of proof for this proposed change lies upon the Secretary of State for Health. I would urge her office to demonstrate how this recent proposal is a proportionate means of achieving a legitimate aim beyond what is currently already in effect, and how this proposed change reconciles with the standard protocol of case-by-case judgments.

In this call for proof, I urge the Secretary of State for Health to consider the broad variety of people who can and do use side rooms and their availability across the NHS. As per NHS Estates documents, increased floor area, capital cost, management, and staffing issues also need to be considered.

Until this burden of proof is met, I am left under the impression that this is yet another attack on trans health that is spurious in nature. I have grave concerns for a potential escalation in medical mistrust already prevalent in the trans community, and how this will impact NHS targets. In particular, the Core20PLUS5 goal of earlier cancer diagnosis for communities with a protected characteristic under the Equality Act.

In closing, I am also acutely aware of the absence of transgender voices in these policy decisions, either through meaningful consultation or co-authorship. I note the lack of duty of care to their wellbeing and its impact on their trust in our NHS. I challenge the idea that a person with lived experience loses objectivity or authority in these discussions. The NHS professes to celebrate and centre ‘expert by experience’ voices, yet in the context of trans rights and access to health, the silence is deafening.