Staff at NHS Fife instructed to use toilets based on their ‘sex at birth’

The change follows a warning from the Equality and Human Rights Commission that it would “enforce” a recent Supreme Court decision confirming that sex in equalities law means biological sex.

The update comes amid an ongoing employment tribunal involving nurse Sandie Peggie, who said she was unfairly treated after objecting to sharing facilities with her transgender colleague Dr Beth Upton. A judge is considering the next steps in her case.

The Scottish government confirmed it had written to every health board to “reinforce the importance of ensuring the law is followed”.

An Equality Impact Assessment (EQIA), published on Tuesday, stated that facilities provided “separately for men and women” should be used by staff “whose sex at birth corresponds with the facility”.

The review also stressed that no employee “should be put in a position that they do not have access to suitable facilities that respect and protect their dignity and privacy”.

Where single lockable spaces cannot be provided, the board said it will ensure “separate toilets and changing facilities” are available for men and women alongside additional gender-neutral options.

A spokesperson for NHS Fife said: “NHS Fife is committed to ensuring that all staff have access to facilities which are safe, lawful, and that respect the privacy and dignity of everyone.

“Our approach includes providing a balanced mix of single-sex, gender-neutral, and accessible facilities so that no staff member is left without access to appropriate facilities.

“NHS Fife will continue to engage with staff and partners to ensure our facilities remain fit for purpose and compliant with current legislation and guidance.”

The board noted that demand for women’s facilities is higher because most of its workforce is female. It also warned that LGBT+ staff “may feel less safe in communal spaces if harassment risk is not managed”.

Helen Joyce of Sex Matters said: “This long-overdue move by NHS Fife to bring its policy on toilets and changing rooms in line with the law is essential for the safety, dignity and privacy of all staff.

“Women’s toilets and changing rooms are not places where female staff should be required to affirm the gender identity of their male colleagues.”

Scottish Trans, however, described the update as “really disappointing”.

Manager Vic Valentine said: “I think that ultimately it’s going to mean that trans members of staff who work for NHS Fife are going to feel significantly more excluded and unwelcome at work.

“And perhaps worried that they’re going to be outed to colleagues about being trans, who perhaps they don’t know well enough to share that information.”

A government spokesperson said: “Following the update to corporate guidance and schools guidance, we have written to health boards to reinforce the importance of ensuring that the law is followed, and the Supreme Court judgement implemented.

“Application of the law following the Supreme Court ruling remains a matter for boards, in accordance with their own legal advice.”

The EHRC confirmed it had required NHS Fife to carry out the EQIA. A spokesperson said: “The publication of an equality impact assessment on the provision of single-sex staff facilities was among the corrective actions we directed NHS Fife to take.

“This is essential to protect NHS Fife staff from discrimination and harassment on the basis of protected characteristics, including sex, religion or belief and gender reassignment.”