13.59 Service providers should be aware that where a transsexual person is visually and for all practical purposes indistinguishable from a non-transsexual person of that gender, they should normally be treated according to their acquired gender, unless there are strong reasons to the contrary."
A pp said the legal issue the EHRC were arguing is how a person with the pc of GR, but does not have a GRC, is treated.
That if a SP restricts services on the basis of sex, that will include those who hold a GRC but exclude those who don’t and this constitutes discrimination on the basis of GR.
I interpret this as meaning that if a SP provider wishes to exclude people on the basis of their sex, it must also justify doing so for people who have the pc of GR, regardless of whether they have a GRC. It must be able to justify this as a proportionate means (there is no other option but exclusion) of a legitimate aim (a service user would reasonably object to the presence of a member of the opposite sex ie on grounds of privacy and decency).
If I apply this example to the NHS Guidance of Delivering Same-Sex Accommodation, Parliament has decided NHS accommodation should be single-sex (except in some circumstances). This is already a proportionate mean, I think (happy to hear arguments otherwise). So men are excluded from women’s wards, but TW with a GRC are included. (But, there is a question whether one can ask a patient if they have a GRC, as generally, ”it would not be necessary to do so”.)
This means the EHRC consider it discrimination on the basis of GR if the NHS accommodate TW with a GRC on a women’s ward, but not TW without a GRC. The EHRC consider them both to have the pc of GR, so should be treated equally.
What the NHS does, is treat both as if they are women. It doesn’t matter whether their phenotype is congruent with their gender identity, (indistinguishable from women) they are women regardless. Because EHRC’s guidance is that you must treat TW who are physically indistinguishable from women as women, and you cannot discriminate between those who hold a GRC and those who don’t, in effect, TW who are distinguishable from women can be accommodated on female wards the same way as those who aren’t. If the NHS includes one, it has to include both.
This is where it gets confusing.
The NHS should offer single-sex accommodation.
Sex is defined in the EA as a man (male of any age) or woman (female of any age). A male of any age is a man, unless they have a GRC which makes them legally female, thus, a woman.
A male of any age, without a GRC, should be accommodated on a men’s ward.
EHRC and judge says the intention of Parliament is to treat those with a pc of GR (regardless of GRC) as different to others of their biological sex. This means that males with pc of GR should be treated as different to males without pc of GR, but doesn’t say they are women, except where the EHRC says you should treat them (those indistinguishable from women) as of their acquired gender. Both judge and EHRC agree this does not automatically confer entitlement to use opposite-sex services.
Judge and EHRC agree that NHS can restrict services on basis of biological sex, but can’t offer such sex-exempt services to those who have GR+GRC, and deny those who have GR-GRC: this is discrimination on basis of GR.
In practice, it seems that restricting services on the basis of sex should also exclude GR, regardless of GRC status, otherwise it’s GR discrimination (seems counter-intuitive to me, so I’m wondering if I’m wrong).
That means NHS (which should offer single-sex accommodation) should exclude males with pc of GR (+/- GRC) from women’s accommodation, invoking 26,27,28 of the scheduled exceptions. To invoke only 26,27 means that women and TW with a GRC can be accommodated on women’s wards, thus discriminating against TW without a GRC, on the basis of GR. So, NHS must exclude all TW from women’s accommodation, to be lawfully providing single-sex accommodation without discriminating on the basis of GR.
The NHS doesn’t do this, it includes all those with the pc of GR as being of their acquired gender and therefore entitled to use opposite-sex services. So we have a situation where single-sex exceptions can be invoked, but aren’t, even though to do so is proportionate and legitimate, and the service is still viewed as single-sex.
The key issue for me, relates to the intention of Parliament to treat those with the pc of gender reassignment, as different to others of their biological sex. This needs to be clarified further. The way the pcs of sex and GR interact mean SPs who should offer single-sex services are including males who must be treated differently to other males, but not automatically as females, and still calling it a single-sex service. Whether this means they can be accommodated on either ward provided they are in a side room, I’m not sure. I think this will also constitute discrimination. It doesn’t seem clear at all. It doesn't even seem clear if the NHS is failing in its responsibility to offer the single-sex service it’s supposed to.