NHS Fife Mandates Staff Use Birth-Corresponding Toilets

NHS Fife has directed its staff to use restrooms and changing facilities that align with their biological sex rather than their gender identity. This decision follows a review prompted by the UK’s equality watchdog, which urged the health board to take immediate action regarding single-sex spaces. The announcement was made public on September 30, 2023, through an equality impact assessment.

The health board’s interim position aims to ensure compliance with legal requirements while providing a mix of suitable facilities. According to the review, “Where toilets and changing facilities are not in individual separate lockable rooms, separate toilets and changing facilities will be provided for men and women alongside additional gender-neutral facilities.” It further states that facilities designated for men and women should be used by individuals whose sex at birth corresponds with the designated facility.

Despite this directive, the assessment emphasizes the importance of accessibility and dignity for all staff. “No one should be put in a position that they do not have access to suitable facilities that respect and protect their dignity and privacy,” the document asserts. The review highlights that the workforce at NHS Fife is predominantly female, which creates a higher demand for women’s facilities. It warns of potential indirect discrimination risks if these facilities are underprovided, distant, or less private.

The situation escalated following a legal dispute involving nurse Sandie Peggie, who was suspended after raising concerns about sharing a changing room with transgender medic Dr Beth Upton at Victoria Hospital in Kirkcaldy on December 24, 2023. Following an allegation of bullying and harassment made by Dr Upton, Peggie has filed a claim against both NHS Fife and Dr Upton, invoking the Equality Act 2010 on grounds including sexual harassment and indirect discrimination. This case has been adjourned until September 2024.

In a statement released on the same day as the assessment, NHS Fife expressed its commitment to providing safe, lawful facilities that respect the privacy and dignity of all staff members. “As part of this commitment, we have published an equality impact assessment (EQIA) in line with our public sector equality duties,” the statement noted.

The health board’s review is designed to ensure that their facilities meet both legislative and regulatory requirements. NHS Fife plans to continue engaging with staff and partners to ensure that facilities remain appropriate and compliant with current legislation and guidance.

This directive from NHS Fife comes on the heels of a significant ruling from the UK Supreme Court in April 2023, which clarified that the definition of a woman under equality law refers to biological sex. Baroness Kishwer Falkner, chairwoman of the Equality and Human Rights Commission, highlighted that NHS Fife had initially not conducted an equality impact assessment, prompting the need for retrospective action.

As NHS Fife navigates these sensitive issues, the health board’s approach reflects a broader conversation about gender identity and the rights of individuals in healthcare settings, balancing legal obligations with the need for inclusivity and respect for all staff.