University Hospitals Sussex drops controversial proposals that would have allowed transgender workers time off to adjust chest binders and genital-hiding underwear
An NHS trust has abandoned controversial plans to give transgender staff extra breaks to deal with chest binders and ‘tucking’ their genitals after the Supreme Court ruled that women are defined by biological sex.
University Hospitals Sussex NHS Trust had drawn up draft guidance suggesting trans colleagues “may require extra scheduled breaks in their shift in order to have breaks from binding and tucking” – practices that doctors warn can cause serious medical harm.
The extraordinary 15-page document, written by employees in the trust’s LGBTQ+ staff network last year, would have been a first for the health service. But the proposals were shelved in February and officially dropped following April’s landmark Supreme Court ruling that the Equality Act refers to biological women only.
‘RISKING MEDICAL HARM’
The draft guidance had suggested providing private spaces for transgender staff to adjust their appearance during work hours, with special consideration for those wearing chest binders – tight garments that compress breasts to create a masculine appearance – or practicing ‘tucking’, where male genitals are pushed between the legs.
Dr Alice Hodkinson, a co-founder of Biology in Medicine, said people binding or tucking were “risking medical and psychological harm”. She warned that tucking male genitals “between the buttocks can cause pain, inflammation, fertility problems and testicular torsion”, while “binding can cause chest and spine deformities, cysts, infections and difficulties breathing.
Dr Hodkinson added that testicular torsion “is a surgical emergency requiring an immediate operation to preserve fertility and sexual function.”
‘WHY ONE GROUP OVER EVERYONE ELSE?’
The proposals sparked fury among NHS staff who questioned why transgender employees should receive special treatment unavailable to other workers with medical or religious needs.
One former employee at the trust said: “If we’re going to make allowances for people who have to use the toilets to change and do this, that and the other, should we not be making allowances for women with heavy periods, or people who have to pray three times a day? Why are we making allowances for one group of staff over everyone else?”
The guidance had also advised staff to “understand the impact of cross-sex hormones” on transgender colleagues, noting that “when someone is prescribed testosterone, energy levels and mood can be lower towards the end of a medication cycle.
SUPREME COURT RULING CHANGES EVERYTHING
The trust’s U-turn comes after “The unanimous decision of this court is that the terms ‘women’ and ‘sex’ in the Equality Act 2010 refer to a biological woman and biological sex,” ruled Deputy President of the Supreme Court Patrick Hodge in April.
The landmark judgment has forced NHS trusts and other public bodies across Britain to review their transgender policies, with many now acknowledging that single-sex spaces must be based on biological sex rather than gender identity.
Britain’s government “has always supported the protection of single-sex spaces based on biological sex,” a spokesperson said following the ruling, which has been hailed as bringing “clarity and confidence” for women and service providers.
‘SELF-HARM IN PURSUIT OF THE IMPOSSIBLE’
Critics slammed the draft guidance as dangerous normalisation of harmful practices.
Dr Hodkinson said the guidance for “employees who are self-harming in pursuit of the impossible goal of sex change should never have made it onto paper, even as a draft”.
Helen Joyce, director of advocacy at Sex Matters, condemned the proposals as “disgraceful”, saying: “Tucking genitals and binding breasts are culturally motivated actions that cause permanent physical damage, just like breast ironing and the use of neck coils. The only difference is that self-harm in the name of trans identity is high status and fashionable.
She added: “This blatant attempt to normalise such a harmful practice is particularly disgraceful coming from a healthcare body. It is a relief to know that NHS Sussex won’t be taking it forward.
TRUST BACKTRACKS
A spokesman for UH Sussex insisted the proposals had never been official policy, stating: “This draft paper is not trust policy or guidance, it never has been, and never will be.”
“A colleague submitted it to a manager in February, for consideration, but it was not accepted.”
The trust, which runs Royal Sussex County Hospital, Worthing Hospital and Royal Alexandra Children’s Hospital among others, had previously made headlines as the first NHS trust in Britain to use terms like “chestfeeding” instead of breastfeeding and claiming that milk from trans women was as good as mothers’ breast milk.
WIDER IMPLICATIONS
The Supreme Court’s ruling has sent shockwaves through the NHS and other public services, with the Equality and Human Rights Commission working “at pace” to update guidance, aiming to provide a new Code of Practice to the UK Government by the end of June.
The British Transport Police said in a statement that it would adopt an interim position that “any same sex searches in custody are to be undertaken in accordance with the biological birth sex of the detainee.
Meanwhile, England Netball updated their policy so that from 1 September 2025 it will recognise female netball, male netball and mixed netball as three distinct gender participation categories with the female category exclusively for players born female.
The controversy comes as public opinion hardens against transgender rights, with 57% saying gender reassignment surgery should not be provided through the NHS and 75% saying puberty blockers should not be allowed for under-16s, according to recent YouGov polling.
