Northern Ireland's health trusts say transgender staff must be allowed to use toilets of new gender - paving way for repeat of Scottish 'Beth Upton' legal case

In other words, if a male staff member announces that he is, in fact, female, then he must be allowed into the women's toilets.

This issue has come to a head in Scotland in the case of a doctor who was until 2022 known as Theodore Upton.

Dr Upton, who qualified as a doctor in 2021, now wears female clothes and wants to be referred to as Beth.

According to reports of the case, Dr Upton has not obtained a Gender Recognition Certificate (an official document registering a change of sex).

A tribunal is under way in Edinburgh because a woman called Sandie Peggie, who has worked as a nurse for over 30 years, was suspended from her job after objecting to Dr Upton using the female changing rooms in a hospital.

The local NHS trust is backing Dr Upton. Ms Peggie is claiming harassment and discrimination. The case has been adjourned until July.

In the wake of the storm which the case has caused, the News Letter asked Nothern Ireland's five health trusts what their policies are on the subject.

All five of the trusts – Belfast, Northern, Southern, Western, and South Eastern – have policies for their staff, but not for patients.

These documents conclude with a sample "memorandum of understanding".

This is a kind of agreement to be signed between each trust and any members of staff who say they are transgender.

The documents state, each in identical wording, under the heading “Single sex toilet facilities”, that "while every effort should be made to deal with concerns amongst staff it should be made clear that once (insert name) begins the process of changing gender identity they will use the appropriate facilities of their new gender".

They go on to say: "It is not acceptable to insist that a transgender person use the facilities of the sex assigned to them at birth or the accessible / disabled toilet. This could amount to unlawful discrimination."

Under the heading "Showers / changing facilities / sleeping accommodation / lockers, etc" the documents add: "Shared use of these facilities to be agreed in discussion with (insert name) and colleagues to ensure that everyone is comfortable with the arrangements and the dignity of all concerned is taken into consideration".

The Western, Southern, Northern, and Belfast trusts all state: "Medical processes are not essential to transitioning. Some people choose not to, or cannot, undergo a medical process but are still transgender."

Four of the trusts (Western, Southern, South Eastern, Belfast) state that their policies exist to ensure "transgender and non-binary people feel comfortable to express their gender identity".

As well as transgender people, all the trust documents speak about "non-binary" people, defining these as "individuals whose gender identity is neither exclusively male nor female, a combination of male and female or between or beyond gender".

All the trusts also speak about gender being a "spectrum", rather than just involving males and females.

The South-Eastern, Southern and Belfast trusts all list the benefits of having a trans policy, saying it "enhances organisational reputation including in the labour market as a progressive employer; reduces risks of high staff turnover and litigation; [and] ensures that the Trust gains maximum contribution from content and productive employees."

In addition, all the trusts sent the News Letter statements using virtually the same language.

Here, for example, is the Northern Trust’s version: “The Northern Health and Social Care Trust has a Gender Identity and Expression Employment Policy in place for staff.

“While there is no specific policy for patients or service users at this time, we continue to provide person-centred compassionate care for all, based on the particular needs of an individual.

"We understand that regional guidance is being developed.”

The Southern, South Eastern, and Belfast trusts said their policies are under review.