NHS ambulance service still allowing transwomen to use women's toilets in defiance of court ruling

By SHAUN WOOLLER, EXECUTIVE HEALTH EDITOR Published: 16:58, 12 July 2026 | Updated: 16:59, 12 July 2026 An ambulance service is still allowing transgender staff to use toilets that match their gender identity more than a year after a Supreme Court ruling ruled against such practices. South East Coast Ambulance Service NHS Foundation Trust has sparked fury among female employees by saying staff are free to use facilities that match their gender identity rather than their biological sex. A 22-page policy, issued by the trust in September – five months after the April ruling – states that transgender employees ‘can use the facilities congruent to their gender identity’. It says it is ‘not appropriate’ to expect transgender employees to use accessible toilets, which are more commonly gender neutral. Instead, colleagues who do not wish to share with a transgender member of staff should use alternative facilities. The Supreme Court ruling last year clarified that the terms ‘woman’ and ‘man’ refer to sex, rather than a person’s chosen gender, under the UK’s Equality Act 2010. The Equality and Human Rights Commission’s recently published Code of Practice says organisations should provide single-sex toilets, changing rooms and similar facilities according to biological sex. Furthermore, the South East Coast Ambulance Service policy warns that deliberately and persistently referring to a transgender colleague by their previous name, or using pronouns that are inconsistent with their gender identity, could amount to bullying or harassment and might result in disciplinary action. Fiona McAnena, director of campaigns at sex-based rights charity Sex Matters, said it is 'shameful' that female paramedics cannot have privacy from men when they use changing rooms or toilets. A female paramedic employed by the trust said: ‘My organisation claims to be inclusive, yet it is so quick to dismiss the rights of women. ‘I am proud of the work I do and provide dignified care to patients every single day, yet I am denied that same basic dignity in my own workplace. ‘When I have attempted to raise concerns, I have been totally unsupported and it makes me feel unsafe.’ She said the trust had a growing number of employees who identified as transgender or non-binary, and staff were expected to affirm their gender identities regardless of their own beliefs. ‘I think many colleagues share my concerns, but they’re too afraid to express them because of the risk of disciplinary action,’ she said. ‘The anxiety is always there. You don’t want to be forced into using compelled speech – into saying that the man or woman you’re working alongside is not the sex you can plainly see they are. ‘It makes you constantly think about every word you use, worried you might slip up and use the wrong pronouns. ‘That’s not a healthy working environment. Focusing on language detracts from patient care in an already pressured environment.’ An ambulance that was decorated to celebrate Pride and used by the team at South East Coast Ambulance Service. Another female paramedic revealed that a male colleague who identified as a woman had used female-only facilities, including showers, when she worked at another trust. ‘It was raised with management, but staff were told there wasn’t anything they could do,’ she said. ‘Female staff started avoiding the facilities, going home to shower and change into uniform instead. ‘Without clear sex-based policies, women feel unsafe.’ Fiona McAnena, director of campaigns at sex-based rights charity Sex Matters, said: ‘It’s shameful that female paramedics at South East Coast Ambulance Service can’t have privacy from men when they use changing rooms or toilets. ‘Their employer is letting down its female staff and breaking the law, which is clear on the obligation to provide single-sex facilities. ‘The demand that paramedics refer to people by their so-called gender identity and use their preferred pronouns isn’t just entitled, it’s potentially dangerous. ‘In a job where people’s lives depend on speed and clear communication, imagine having to worry about remembering to call a man “she”.’ The guidance forms part of the trust’s ‘procedure for supporting transgender employees and service users’, which covers a wide range of issues relating to transgender employees and patients. Meanwhile, its menopause policy states that references to ‘women’ include ‘trans men, non-binary and some intersex colleagues’. It also says trans women may experience ‘menopause-like symptoms’ if hormone treatment is interrupted. South East Coast Ambulance Service appears to be the only one of England’s 10 NHS ambulance trusts to publish transgender staff guidance on its website. A South East Coast Ambulance Service spokesman said: ‘Our Equality, Diversity and Inclusion (EDI) Policy is currently under review. ‘As part of this review, and as national statutory guidance is finalised, we are also reviewing associated policies and procedures to ensure they remain aligned with current legislation, case law, NHS guidance and best practice. ‘We are committed to providing an inclusive working environment for all staff and delivering services that are accessible and equitable for the diverse communities we serve.’