An NHS trust has come under fire over internal trans guidance policy which, campaigners warn, obliges staff to 'comply or be damned'.

Senior management at Lewisham and Greenwich NHS Trust signed off on the 18-page document which forces medics to accept patients' choice of pronouns.

It also warns they should not confront patients who use specific single-sex facilities – regardless of their appearance.

The policy, which came into effect in February last year, commits staff to apologise if they make mistakes relating to a patient's pronouns. It also advises they make a 'commitment to try harder' if they make errors in front of patients.

Other sections of the policy, which is not due for renewal until November 2026, read: 'Patients may need to be screened for risks linked to their physiological needs… based on what organs are present rather than the patient's birth or acquired gender.

'Trans men and non-binary individuals can become pregnant and should be treated with dignity while using maternity services.

'[If] it is impossible to ask the view of the person because they are unconscious or incapacitated then, in the first instance, inferences should be drawn from presentation and mode of dress.'

The document has been met with a wave of criticism. Heather Binning, of the Women's Rights Network, said: 'The policy incorrectly interprets UK law and places staff and patients in extraordinarily difficult positions.

'The coercion and bullying of NHS staff through these unlawful policies is clearly evident… Comply or be damned. Where's the dignity and respect for women who are uncomfortable accepting men in their spaces?' 

James Esses, founder of Thoughtful Therapists and who first received the policy, said: 'This ideology, which threatens the wellbeing of children, the safety of women and the values of free speech and biological reality, must be driven out of our healthcare system before it is too late.'

The policy is an example of what former health secretary Steve Barclay described as 'wokery' within the NHS and promised to eradicate. 

Last year Mr Barclay vowed to reintroduce sex-specific language when dealing with women's health – a position endorsed by current Health Secretary Victoria Atkins.

The document has been revealed in the wake of the landmark Cass Review into NHS England's gender identity services for children. 

Published last month, it found children had been set on the path to irreversible change despite 'remarkably weak evidence'.

It is understood Lewisham and Greenwich Trust reviewed its policy in light of the Cass Review but concluded that it did not need updating.

A spokesman for the trust said it 'is committed to being an anti-discriminatory organisation, ensuring that we provide an inclusive, safe environment and equitable care for all our patients in line with the Equality Act 2010.

'We are proud of our trans policy, which ensures that we treat trans patients… with the same high level of dignity and respect offered to all patients.'