Why the Supreme Court ruling matters for health

The first step is telling the truth: you cannot change sex – and pretending otherwise puts patients in danger. Reality matters in every corner of healthcare.

NHS leaders and regulators have enabled an ideology that denies basic biology and its central role in delivering safe healthcare to the population of the UK and Northern Ireland. Being a woman is not about your clothes or makeup – it is a biological reality, and that reality matters in every corner of healthcare. We care as a group doctors and colleagues to see evidence-based medicine for all patients regardless of how they may identify.

The UK Supreme Court has now confirmed what should never have been in doubt: the word “woman” in law refers to biological sex, not gender identity. This has enormous implications for healthcare delivery, policy, and safeguarding.

Women – both staff and patients – have been denied same-sex spaces and care. Intimate examinations are being carried out under unclear chaperone policies, and women requesting female clinicians are often dismissed. The General Medical Council (GMC) has allowed doctors to mislead patients by recording their gender identity rather than their biological sex on the medical register.

One such case involves Dr Upton (Peggie v NHS Fife), who publicly stated he would see a woman patient requesting a female doctor without disclosing he is male, and only leave if asked. This breaches the GMC’s own guidance to respect dignity and privacy and highlights how women are being stripped of informed choice and consent in intimate care settings.

The Sullivan Review has warned of the damage caused by corrupting sex-based data. From differences in disease presentation to blood reference ranges and access to screening programmes – all of this depends on accurate sex-based information. Yet NHS records are being altered based on self-identified gender, not legal documentation.

Safety is also a real-time clinical issue. In acute scenarios, such as diagnosing a heart attack, blood tests differ significantly between men and women. Consent may not be fully informed, because sex-specific risks and outcomes are obscured. And the NHS, which has the best population health data in the world, is now collecting distorted information – compromising research, care quality, and resource planning.

Language has been so ideologically skewed that many women no longer recognise themselves in public health campaigns. Referrals for cervical or breast screening are sometimes written in language that avoids using the word "woman" altogether, adding confusion and reducing uptake.

The Cass Review has exposed the weak evidence base behind the use of puberty blockers and cross-sex hormones in children. Vulnerable, gender-confused young people – particularly girls – are being misled, fast-tracked down a path of experimental drugs, mastectomies, and hysterectomies. Gender identity clinics have advised patients to use facilities that match their identity, not their sex. This advice must now end. Ideology has led to irreversible harm – and a profound sense of betrayal for those who were promised “affirmation” but left with regret.

We call for the GMC to be held accountable for its role in undermining patient safety. Instructing GPs to change sex markers and names in medical records without legal verification puts lives at risk – particularly in emergencies, where knowing a patient’s sex could be the difference between life and death.

The NHS is in crisis – not just from underfunding, but from abandoning evidence and ethics. It is time for the government to step in. Science and safeguarding must be restored without compromise. The first step is telling the truth: you cannot change sex – and pretending otherwise puts patients in danger.