Hospitals are breaking the law by continuing to allow trans women to use female facilities in defiance of the landmark Supreme Court ruling on single-sex spaces, NHS bosses have been warned. Campaigners said female employees are being forced to work in a ‘degrading and humiliating’ environment because trusts are still following outdated advice that says transgender people should use the toilets and changing rooms they feel most comfortable with. They urged the NHS Confederation to withdraw its ‘legally illiterate’ guidance immediately in the wake of last month’s far-reaching judgment that the definition of a woman is based on biological sex rather than gender identity, which has already led to those born male being barred from female football, netball and cricket. Maya Forstater, of women’s rights charity Sex Matters, wrote to the umbrella body’s chief executive, Matthew Taylor, to say: ‘The Supreme Court has now put it beyond all doubt that the terms “man” and “woman” in the Equality Act refer to biological sex and single-sex services. ‘Yet the NHS Confederation is still refusing to take responsibility and withdraw its guidance and tell its members it was wrong.’ She warned: ‘Those [trusts] that are following the current guidance from the NHS Confederation are breaking the law. There is no reason for delay. ‘The fact that your guidance is “informal” is no excuse. It encourages NHS employers to uphold policies that create an intimidating, hostile, degrading, humiliating and offensive environment for staff who do not wish to share single-sex spaces with members of the opposite sex, and to breach workplace health and safety rules.’ As the Mail revealed two years ago, the NHS Confederation’s guide also claimed patients have no right to know if they are being treated by a transgender doctor or nurse. It said patients cannot request a same-sex staff member ‘if there is no clear clinical benefit’. Even those with dementia ‘should still be challenged’ if they express discriminatory views while their relatives should be ‘removed from the premises’ if they do the same, the 97-page document recommended. It stated: ‘Trans and non-binary people should be supported to use the bathrooms they feel most comfortable using. ‘At no time is it appropriate to force staff to use the toilet associated with their assigned sex at birth against their will.’ The guidance was raised in the House of Lords last week with Tory peer Baroness Jenkin, who said: ‘I ask the minister to join with Sex Matters, which has written to the chief executive of the NHS Confederation, in urging it that its current guidance is unlawful and should be withdrawn as a matter of urgency.’ Health Minister Baroness Merron insisted: ‘On guidance, the noble Baroness, Lady Jenkin, simply demonstrated the need to get language right throughout... That is exactly what will happen.’ Health Secretary Wes Streeting has promised that fresh guidance for NHS trusts will be published before the summer and that he will not tolerate those that break the law. However the British Medical Association’s resident doctors committee has dismissed the Supreme Court ruling as ‘scientifically illiterate’. There are also still tribunal cases ongoing over the ability of trans women to use female facilities in the NHS. A group of nurses from Darlington are taking their bosses to an employment tribunal over the policy that allows a trans colleague to use the female changing rooms, with a hearing not due until October. And in Scotland, nurse Sandie Peggie’s case against NHS Fife - in which she claims she was subjected to harassment by being made to share a changing room with a trans doctor - is due to resume in July. A spokesman for the NHS Confederation admitted last night: ‘Following the UK Supreme Court ruling and the subsequent interim guidance from the EHRC, we recognise that elements of our guide on trans and nonbinary allyship are now dated. ‘This has been reflected in the document and on our website. We understand our members will want to take the ruling and interim guidance into account in their local policies and decisions. Up until this point, our guide has been based on the Equality Act 2010 and the advice from the EHRC as it stood prior to April 2025. ‘We will update the guide more fully as soon as the Government has responded to the EHRC’s updated Code of Practice after it has been publicly consulted on, so that the implications of the judgment for NHS services are fully known. ‘We will continue to work with our members while we do this. The resource on our website remains as guidance and is not official policy for the NHS.’