Updated BMA guidance on rights for trans staff

[AnonMedic]

The latest update to this policy is 12th February 2026. Highlights include:

Staff should use facilities that match their gender identity.

Patients can request same gender care but have no right to know the sex of their practitioners. (Neither do employers.)

Obviously the BMA is essentially a trade union, and these positions are in line with other unions - and there is of course a conversation to be had about whether they would stand up to legal challenge. But the difference between the BMA and eg UCU is the impact on patients.

I actually think it’s not unreasonable to take the position that gender identity, like sexual orientation, is largely irrelevant at work, and I certainly wouldn’t start a discussion with colleagues or patients by saying “hi, I’m AnonMedic and my sexual orientation is x, my gender identity is y, and my sex is z.” But the BMA is (deliberately?) missing the point here; patients don’t tend to request same gender care - they request same sex care. There’s an interesting podcast where Michael Foran interviews Timothy Pitt-Payne KC about whether there is ever a reasonable expectation that sex is private. Legal commentary aside, it is clearly possible to honour requests for same sex care without trans medics needing to tell patients their sex. For example, patient x tells doctor y, who has a female gender ID and is of male sex, that she will only consent to a vaginal examination done by a doctor of the female sex. “No problem”, says dr y. Dr z then arrives and says something like “dr y has been called away, is it ok if I carry out your vaginal examination?” (Does dr z need to be told dr y’s sex? Putting to one side the fact that dr z will likely deduce that for herself, the answer is “no”. She just needs to know that the examination needs to be done and that dr y can’t do it.)

My other observation here is that the BMA is in line with the GMC which says that they don’t expect practitioners to disclose their sex as part of the consent process. I wonder whether that policy would stand up to a judicial review, especially in light of case law around consent. For example, if consenting to have your foot examined you might agree that the sex of the clinician is not relevant - but you might feel differently for a vaginal examination. (And of course for some religious women, the clinician’s sex would be relevant for the foot examination.)

I really think a judicial review of GMC policy is needed here. Patients need to know if they have a right to same sex care, and doctors need to know where the line between their right to privacy, and their patients’ rights to privacy, should be drawn.

(The changing room policy should obviously be amended to be in line with the law. Will it take a union being named as a responding party to sort this out?! SP is also suing RCN, but I think that is to do with them not supporting her claim rather than their policies on changing rooms.)

https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance/lgbtplus-equality-in-medicine/policy-position-on-the-rights-of-transgender-and-non-binary-people-in-healthcare-settings

Can't wait until the next court case.

It is certainly bringing the medical profession into disrepute.

Perhaps a problem that can be skated around in some professions, but not in healthcare.

The transport unions might be unpopular with commuters, but I don't think they have ever given the impression that train drivers and staff are incompetent or dangerous.

@AnonMedic
My other observation here is that the BMA is in line with the GMC which says that they don’t expect practitioners to disclose their sex as part of the consent process. I wonder whether that policy would stand up to a judicial review, especially in light of case law around consent. For example, if consenting to have your foot examined you might agree that the sex of the clinician is not relevant - but you might feel differently for a vaginal examination. (And of course for some religious women, the clinician’s sex would be relevant for the foot examination.)

I agree. As I posted on another thread, I don't understand why someone's sex is so important for an intimate sexual encounter that if they lie about it they can be sent to prison; but for an intimate medical examination it is "irrelevant."

If I want to be touched only by a man or a woman, I should not be misled that that is what is happening when it isn't.

I also think that employers now do have the de-facto right (and even the duty) to know the sex of their employees. They have a statutory requirement to provide single-sex toilets and that can only be done if they are able to confirm (if it becomes necessary) that people are using the toilets that align with their sex.

If there's a duty in law, then the information reasonably required to comply with that duty must be gathered and kept by the duty bearer.

I also think that if someone lies about their birth sex on a job application form it's as serious as if they lied about the qualifications or education. It prevents the employer from meeting an obligation to their other staff.

Which makes me think of that trans-identifying GP who wanged on (in the press?) about how lovely it was that he could now intimately examine all the religiously observant women in his practice without them being allowed to object knowing.

Under the Kemp judgment (so long as it stands), it's harassment to not immediately separate the two and stop requiring the woman to go along with it.

However I would think the woman has a bloody strong case in law that it was not only harassment to send in a man if she has requested a same sex hcp, but further legal issues as they attempted to deceive her into something she had refused consent to. And that would likely be against both the hospital and the hcp personally, because 'I attempted to deceive her into acting against her consent because they told me to' probably isn't going to fly well.

But whatever, their funeral and PR disaster. I hope the woman they do this to gets a big payout and that it sets this even further into law since caselaw seems to be the only way to get anything done. Doing this to women for men's egos really isn't defensible.

I suppose there are complicated ways around it all such as the hospital saying to a woman 'are you comfortable with a trans identified man providing your care' to get consent, but they would need to specific to ensure all women understood regardless of EAL and other needs that this is a biological man. However women who don't mind about this aren't likely to have asked for or wanted a same sex hcp, same sex means actually same sex, and it means making sure everyone knows the man in question is trans identified. It would seem much simpler and politer to everyone involved to just have a policy as with police searches that trans members of staff are exempt from providing care on a same sex basis. Yes, obvious possible issues with staffing and practicality and etc but staffing plans will need to be written with this in mind.

Yes. Absolutely yes. Someone's desire to 'stealth' handle a patient who has refused consent should raise very serious questions about their intentions and their fitness to be in such positions of responsibility. Other people's bodies are not tools for personal validation, this is a frank and inexcuseable abuse of a position of trust.

It has to be made very clear to boys and men that putting themselves, even in absolute innocence, into women's spaces and positions leaves them wide open to serious accusations and misinterpretations before they've done more than walk through the door. But to intentionally 'stealth' others is not innocent in any way.

It's also odd to insist that there is a right to complete privacy when the GRA allows that sex is relevant to a relatively trivial thing like sport, and a public thing like the inheritance of a title.

I also never understood how Goodwin was supposed to be able to hide his sex unless he disavowed his 4 children.

@AnonMedic here's 1 that really proves the lie in that GMC statement, last year I badly sprained my ankle and needed 6 months of physio. My physio was male and I needed to sign a waver to specifically allow a male physio to treat me even though he never touched me above the knee. Now I understand that its a standard waver for all male physios to protect themselves from allegations but if I didn't have the right to know that he was a man however can I be required to sign a waver for a male physio to treat me.

Oh and just to add a bit of irony this was NHS Fife and their own policy

I've been retired over two years & no longer need the services of the BMA. I don't have the time or inclination to read the BMJ every week any more. This policy was the final straw that tipped me into cancelling my membership. I explained that the advice is contrary to FWS in the Supreme Court & the GLP/EHRC in the High Court. I also strongly disagree about providing "gender affirming care" to anyone & definitely not on the NHS.

The BMA are a disgrace.

I'm sure many TIMs would request same gender care rather than same sex care

I disagree with the NHS giving any kind of treatment to anyone that they can't explain, and I have never heard any coherent explanation of what a gender is and how it can be affirmed.

Sorry no time to read other comments so someone may have already made this comment but, this is complete nonsense:

Patients can request same gender care but have no right to know the sex of their practitioners.

Gender is NOT despite what some try to tell you, how the majority of people think about themselves.

How can they possible suggest these are guidelines when in fact what they have written implies they are ignoring the issue.

ie that sex is real (and how most people think about themselves) so suggesting guidelines based on "gender" is sticking two fingers up to everyone.

If it wasn't so important I would say this is just childish twaddle.

Perhaps we should all ask for non-binary practitioners - this would 'align' with a self image that may not be externally expressed.

How could anyone question you, no one knows what non-binary gender actually means?

I agree. Gone are the days when use of gender was interchangeable with sex.

This ⬆️

And by extension, the Passport Office presumably needs to stop changing people's sex from M to F (or vice versa) on passports when someone submits a request for this.

They are creating documents that allow employees to falsify their sex when applying for jobs.

It gets trickier for the Passport Office to know what to do if the person has a GRC, but they really don't have any excuse if no GRC is involved. In a sane world it should be simple: nobody should ever have their sex changed on a passport, birth certificate or other legal document, with or without a GRC, because sex (biological, immutable fact) and gender (social construct and an unfalsifiable belief in the idea that we all have a gendered soul) are not the same thing. Allowing documents which are supposed to be factual to be changed based on how someone feels is ridiculous.

The PP office should have access to the list of GRCs or require it as a proof of name change. The creation of a new ID with a change of sex should be seen as a security risk and an opening to criminal acts eg financial fraud.

Lucky you. I had a breast exam by a male consultant who called for a nurse to chaperone. When I opened my eyes at the end I discovered it was a male nurse who had been gazing at my naked top half.

I was deeply shocked.

This was in 2019 in Fife.

I think it’s ridiculous that birth certificates are allowed to be altered by a GRC. In no other situation is this allowed. If a child is adopted, the original birth certificate still exists. If you get divorced your marriage certificate still exists. The only time sex on a birth certificate should be allowed to be changed is in the (very rare) circumstance where it’s been wrongly recorded due to DSD. It all falls back to the assumption that the person transitioning “passes” so completely that you can’t tell.

I was stunned when I discovered a few years ago that the medical profession solidly supports this Men’s Rights movement. It’s so deeply misogynistic — how do they balance this with their caring role?

It would tie into the women in medicine who suffer from sexism. The whole doctor = male has been an issue. Add in the women are the same as men was taken as literal which is why some female medical staff felt the need to write sex out of all process whthout taking account of the need to recognise the default body is a male one

Plus the conflict with informed consent that an individual can refuse care due to sexism or racism being a problem flows into male claiming to be woman is the patient being a problem.

That the individual should be "grateful" and unquestioning when seeking medical help. I have seen the same attitude with some tictok teachers who think because they have An Education their role should be placed above the parent-child relationship.

The concept of a chaperone is not a same sex buddy but an independent HCP observing the examination. This protects both the patient & the doctor.

I know that now, but I didn’t know it then. I doubt I am alone in that.

I still think that exposing my naked chest to a male I had never seen was a violation of my tacit consent. I should have had the option of asking for a female observer.

I think as in every other spheres the reasons why TRAs have been so sucessful is because it is built on the long existing and well established dominance of the MRA culture. ie Pariarchy.

And especially the medical profession, like the law, has been deeply damaged in who it actually works by the patriarchal and class structure it operates on.

When I was younger I was taken aback by the sort of deference to consultants (9.9% male). And sadly this still exists.

Recently I had a consultant appointment, and even before I got there I was told in husted tones how lucky as was as the superior being kindly came to the local hospital one day a week, etc., etc.. He was in fact quite approachable and helpful but I was astonished that he had a junior doctor (female) who sat there doing his data entry. (One of the impacts of introducing computerised systems is in fact spending half your appointment not engaging with the doctor / consultant because they are so focused on updating the computer records).

And from an old thread, not forgetting that when there was such a need for PPE during Covid it turned out most were only suitable for men and it left female staff unprotected as they were too loose, etc., etc..