NHS trust uses derogatory ‘terf' slur in official guidance

Telegraph

03-05-2025

An NHS trust has come under fire for using the derogatory term 'terf' in a guide on how to support transgender staff.
In documents drawn up by the North East London Foundation Trust (NELFT), the guidance uses the slur, which stands for 'transgender-exclusionary radical feminist', to describe women who do not want to share single-sex facilities with trans women.
The document also claims that it is 'unlawful' to exclude trans women from women-only spaces around the hospital.
It comes after the Supreme Court ruled the opposite two weeks ago, declaring that a woman is defined by biological sex under equality laws.
It means those born male are not able to access a women-only space even if they have changed the gender they identify as, and provides clarity following high-profile disputes such as the case of the Dr Beth Upton, in which transgender NHS staff have used women's changing rooms or lavatories.
After the use of the offensive term was flagged to the NHS by The Telegraph, officials warned the trust not to use 'derogatory or dismissive language', while the trust itself said its guidance was now under review.
NELFT, which specialises in community and mental health, provides services to people in parts of north and east London as well as Essex and Kent.
Its staff policy, obtained under Freedom of Information laws, is called 'supporting colleagues who identify as transgender, non-binary and other gender identities'.
Within this document it refers to 'trans-exclusionary radical feminists', also known by the acronym 'terf', stating that this group 'may feel that trans inclusion is an infringement on their beliefs or values'.
The term appeared on numerous placards during a protest by trans activists in central London against the Supreme Court ruling last week, with the Metropolitan Police reviewing death threats made against women.
Signs included phrases such as 'the only good terf is a ---- one', alongside the image of a hangman's noose.
Fiona, a women's rights campaigner, told The Telegraph the slur was used to silence and 'incite violence against' women.
'Given that the term terf has been used to dehumanise and silence women it is particularly egregious that this slur is used in the Equality Impact Assessment which is supposed to be the fair and balanced legal section required under the Public Services Duty in the Equality Act,' she said.
In regards to the stance taken by NELFT against its female employees who do not want to share single-sex facilities with trans women, she said: '[The] Supreme Court has now confirmed that this was just not just a problematic feeling – it is and always was the law.'
NELFT's staff guidance was authored by EDI managers and LGBTQ staff network leaders and signed off by two executives.
It was published in the months after Maya Forstater, the co-founder of charity Sex Matters, won a landmark employment tribunal in 2021 that declared 'gender-critical beliefs' were protected and should be respected in a democracy.
Helen Joyce, director of advocacy at the charity, said the NELFT's attitude towards women 'reflects the abysmal response from many NHS trusts to the Supreme Court judgment'.
'Terf is a term used by trans activists to demonise women who are working to restore and protect hard-fought rights to single-sex services and spaces,' she said.
'By the time this guidance was published, Forstater v CGD had already established that gender-critical views are legally protected, further illustrating the long-standing contempt for the law within the NHS.'
The trust's guidance also makes claims 'some cisgender people have unlawful discriminatory views of trans people using single-sex spaces such as using gendered toilets'.
Like other trusts in London, its single-sex accommodation policy for patients allows trans women to share wards and lavatories with women. It also has a 'gold award' from the controversial charity Stonewall for its 'commitment' to LGBTQ policies.
It comes as a wing of the British Medical Association (BMA), the leading doctors' union, has been accused of 'destroying trust in medicine' and perpetuating 'medical misogyny' after some members condemned the Supreme Court's ruling.
Its group of resident doctors – formerly junior doctors – passed a motion last week calling the verdict ' scientifically illiterate ' and 'biologically nonsensical'.
The motion is not yet BMA-wide policy but it is likely to be voted on at its annual meeting in June.
Biology in Medicine, a group of doctors who campaign for patients to be treated according to their biological sex, said: 'Activists are destroying trust and integrity in our profession. The denial of the biological reality of sex by the BMA is the culmination of a few activists infiltrating key BMA committees and forums.'
'Medical misogyny is huge problem'
Dr Louise Irvine, the co-chairwoman of the Clinical Advisory Network on Sex and Gender, said: 'As a doctor, you need to know sex for accurate diagnoses. Sex matters for NHS service provision and single-sex wards.
'It is misogynistic to negate or ignore women's rights. Medical misogyny is a huge problem. The profession has a long, long history of misogyny. Now the BMA is making out that sex is a nebulous concept and category.
'If doctors don't understand sex then I don't think they should be doctors.'
An NHS spokesman said: 'Organisations across the NHS are reviewing their policies and guidance to bring them in line with the Supreme Court judgment, and this will take some time. Guidance for staff should clearly not include derogatory or dismissive language, and trusts must take this into account as part of their reviews.'
A Department for Health and Social Care spokesman said: 'Single-sex spaces are protected in law and will always be protected by this Government, and we expect Trusts to follow the clarity that the Supreme Court ruling provides.'
A spokesman for NELFT said: 'We are reviewing the content of the guidance in light of the recent ruling, as well as the language used to ensure it is respectful and promotes inclusivity, and we will reissue once complete.'