GMC - sex-based registration

[NebulousHog]

I'm just going to start a thread here for all the queries, questions, and concerns that have come from the Dr Upton case regarding the GMC. I'll write a little note shortly on why this has come about (abridged version), and I will also be contact Sex Matters with some queries about potential legal proceedings around same-sex care provision for women.

That’s really useful. How can they offer employees protection under the equality act without knowing?

If only that was true.
Hospitals only record the gender identity of staff, this is why women who have asked for female only care are told that it can't be guaranteed, whilst others have turned up to appointments only to find a man in a dress.
Then ofcourse you have Dr's like Dr Upton who have stated on record that they will purposely treat women who have asked for a female Dr unless she specifically says no to him in the room when she's vulnerable and alone with him, Dr Upton isn't the only male Dr who behaves in such a manner just the most widely reported on.

So basically we can't trust the men, hospitals or the GMC to be honest and that's a problem. No Dr should ever be allowed to hide or lie about their sex and it should be publicly available on their registration

Thanks @KnottyAutyfor the podcast recommendation. I’ve since listened to both episodes - which are highly relevant to this thread.

The issue of whether sex is private in any given situation and whether/where it can be kept private is going to come up more and more as the SC ruling beds in.

When it comes to intimate care, it is now very clear that, in law, ‘same sex’ is determined by gonads, chromosomes and genitalia. TRAs have very helpfully pointed out that many people don’t know their chromosomes, and genital inspections are untenable. To uphold the law/to avoid litigation, due diligence will need to be undertaken by service providers.

If the GMC doesn’t provide sufficient scrutiny for employers to rely on to determine the biological sex of members of staff who may be involved in providing intimate care, they will need to introduce other checks and balances. I don’t think a defence based on using GMC data will hold up.

The captured regulatory and advisory organisations/ unions who behaved unlawfully and promoted the law that they wanted (as opposed to what is lawful) can continue to do as they wish, and risk the consequences. Service providers, like NHS Trusts, cannot hide behind them and say ‘they said…..’. There are plenty of women who have kept the receipts detailing how they alerted Trusts/ providers/ prisons/ refuges that their policy has denied their rights and ignore the law.

I wonder if the next step is FOIs to find out who their indemnity insurance provider is and writing to them to share the unlawful policies/practices.

Failing to secure indemnity insurance will give Trusts who are willing to change a face saving way out. They can chant apologies to their trans sisters saying their hands are tied. For those who will only go down once they have taken their last breath - no insurance will result in their last breath.

Protections are required through inclusive and proactive policies. An employee is not required to disclose their protected characteristics in order to be protected from detriment. The law requires all reasonable measures to be in place regardless.

Brainworm: "I wonder if the next step is FOIs to find out who their indemnity insurance provider is and writing to them to share the unlawful policies/practices."

Basically, it is Government rather than commercial providers.

Indemnity insurance for NHS Trusts and GP Practices in England is provided by NHS Resolution which is "part of the NHS, operating as an arm’s-length body of the Department of Health and Social Care (DHSC)"
https://resolution.nhs.uk/corporate-publications/resolution-through-collaboration-2025-28-strategy/who-we-are-and-what-we-do/

In Scotland's NHS the same function is provided by National Services Scotland:
https://www.nss.nhs.scot/browse/legal/litigation

NHS Wales has "Risk Pooling Schemes":
https://nwssp.nhs.wales/ourservices/welsh-risk-pool/indemnity-and-welsh-risk-pooling-schemes/

In Northern Ireland the NHS Indemnity Schemes are funded by the Department of Health, Social Services and Public Safety but are administered by NHS Trusts:
https://www.health-ni.gov.uk/

The employer has vicarious liability for actions of the employee when carrying out the business of the employer.

Individual Health Care Professionals will usually have their own insurance cover as well, whether directly with an insurance company or as part of a package with their membership of a trade union or professional organisation.

The GMC has this advice for medics:

Insurance, indemnity and medico-legal support
Statutory requirement for doctors to have insurance or indemnity
https://www.gmc-uk.org/-/media/documents/insurance-and-indemnity-guidance---dc3224_pdf-50552480.pdf

Kicking myself now that I have yet to read up on the Sandy Peggie case and the different grounds for taking NHS Fife and Dr Upton to court!

Thanks @POWNewcastleEastWallsend.

I thought that NHS Resolution covers clinical negligence but employment disputes fall outside of its remit. I was imagining that this issue would boil down to HR policies? I’m not confident about this as my work is clinically focussed

I was coming at it from the patient's angle, ie. a complaint from a patient about failure of the Trust to provide a same-sex practitioner as requested.

Brainworm - I have had another root around the NHS Resolution website. This covers England so it might be different in Wales, Scotland and Northern Ireland.

Non-clinical schemes

We also manage two non-clinical schemes under the heading of the Risk Pooling Schemes for Trusts (RPST):

• Property Expenses Schemes (PES) which covers ‘first party’ losses such as property damage and theft, for incidents on or after 1 April 1999.
• Liabilities to Third Parties Scheme (LTPS) which covers non-clinical claims such as public and employers’ liability.

In addition we manage one other non-clinical scheme:

• DHSC Non-clinical which covers non-clinical negligence liabilities that have transferred to the Secretary of State for Health and Social Care following the abolition of any relevant health bodies.

Page last updated on: 2nd April 2019

https://resolution.nhs.uk/services/claims-management/non-clinical-schemes/

Liabilities to Third Parties Scheme

Our Liabilities to Third Parties Scheme (LTPS) typically covers employers’ and public liability claims from NHS staff, patients and members of the public. These range from straightforward slips and trips to serious workplace manual handling, bullying and stress claims. LTPS covers claims arising from breaches of the Human Rights Act, the Data Protection Act and the Defective Premises Act, as well as defamation, unlawful detention and professional negligence claims.

LTPS also extends to cover the personal liabilities of the members of NHS boards, including non-executive directors. Personal injury cover is unlimited in value and there is no limit on the number of claims members may make in any membership year.

Page last updated on: 2nd April 2019

https://resolution.nhs.uk/services/claims-management/non-clinical-schemes/risk-pooling-schemes-for-trusts/liabilities-to-third-parties-scheme/

Age Discrimination & Equal Pay

Also covered.

https://resolution.nhs.uk/services/claims-management/other-services/

Trusts will have in-house legal services and/or will procure outside legal services and the costs of meeting some successful claims or settlements have definitely come out of Trust budgets

I do not know if NHS Trusts are permitted to buy commercial insurance to cover other types of successful claim, eg. of discrimination under the Equality Act 2010, or if it would be financially viable. Maybe some test FOIRs to Trusts would help?

For example, years ago I had to look into the cost of insuring a stock of specialised non-consumable medical equipment against theft and non-warranty damage. It was so ridiculously high that it was unfeasible and it was a better use of the budget to include the cost of any replacements and repairs needed.

I’m going to have a think about this over the next few weeks and will try to draft a complaint to the GMC around this privacy and Article 8 human rights. At the moment they solely prioritise gender reassignment on a self Id basis. That ignores GRCs and women’s rights. Hopefully they will listen but if not they have their own regulator (who covers lots of other medical regulators). So I’ll have a go at drafting something and maybe you can help me sense check it? Not sure yet but it would be aimed at the GMC’s Fitness to Practice advice…

If a single sex service is being provided then the legal sex based discrimination is being invoked. No member of the opposite sex can be 'included'. The law is now entirely clear on this.

This means the GMC accepting that men cannot be sent to do a job that other men would not be allowed to do on the grounds that he is special due to gender based reasons.

This will have to mean that managers are aware of who to send to do which jobs in which circumstances in the same way as the police will have to know who is quietly exempt from carrying out strip searches. There is no other option. And it would be a part of protecting employees with trans identities from being put in difficult situations or required to have difficult conversations on the spot, which they may manage to care about, if not about anyone else.

The issue of men intentionally trying to get into these intimate situations with women for their own gratification would seem straight forward abuse of trust and deception, to be handled via standard disciplinary process as any other incident of an employee seeking to use their position to commit an assault. As that is what it would be. I cannot imagine insurance being willing to protect anyone against this, and insurance for practitioners must be set within parametres of practice guidance and policy as being a workplace anyway with higher risk of accusation than many others. If intimate contact was involved, with the law now clarified, I would think the woman would have a good case to argue assault by deception too. Particularly if something stupid was attempted like the whole 'tee hee hee she may not know and I might successfully fool her into letting me abuse her' view. Which sadly is a fairly often heard one from the GI lobby.

The woman certainly can no longer be punished or silenced/intimidated into submission. Which was a big part of trying to enforce men's access to this form of abuse, and avoid negative PR that would add support behind the woman.

The privacy issues will have to be balanced with the rights of others, in particular the choice of that individual to make this a complicated matter for their own reasons. It will be interesting to see if insurance evolves to begin to ask questions regarding this as health/disability questions are necessary to ensure who is appropriate for which task, and insurable in that situation.

Sorry I have been quoting the number of GRCs wrong all weekend. Doh! Sorry

It’s not 8400ish but currently 9633.

https://www.telegraph.co.uk/news/2025/06/16/thousands-of-gender-recognition-certificates-granted/