The UK equalities regulator says it is considering whether to use its enforcement powers following recent correspondence with NHS Fife.
The Equality and Human Rights Commission (EHRC) had earlier sought to remind the health board of its “obligations” under equalities legislation.
It said assessments of new policies and practices which affect equalities legislation must be published.
The intervention came amid a high-profile employment tribunal brought against NHS Fife by nurse Sandie Peggie – who was suspended after she complained about having to share a changing room with transgender medic Dr Beth Upton at the hospital where they both worked.
Chaired by Baroness Kishwer Falkner, the EHRC has powers to carry out investigations and apply for interdicts in the Scottish courts, if it believes organisations are not complying with equalities law.
The Daily Telegraph reported an exchange of letters between the EHRC and NHS Fife.
One of these was a March 27 letter from NHS Fife chief executive Carol Potter to EHRC chief executive John Kirkpatrick.
She said: “We recognise the significant media attention and public discussion this issue has generated.
“However, as with any complex legal and organisational matter, not all facts or considerations may be fully reflected in external reporting.”
She said the health board recognises its responsibilities under the Equalities Act 2010, saying that the current legal process must conclude before any potential changes to practices can be considered.
NHS Fife is “committed to fostering a safe, inclusive, and non-discriminatory environment for all staff and patients”, the chief executive said.
Ms Potter also said NHS Fife is also awaiting the publication of a national “gender transitioning guide” from NHS Scotland which will inform policy.
A spokesperson for the EHRC told the PA news agency: “The policies and practices of all Scottish health boards must comply with the Equality Act 2010, as it relates to the provision of single-sex services and spaces.
“We wrote to NHS Fife to remind them of their obligations under the Public Sector Equality Duty, and request that they provide information relevant to the provision of changing facilities for their staff and the rights of different groups in the application of these policies.
“We are currently reviewing the response NHS Fife provided and will be writing to them again shortly.
“As Britain’s equality regulator, we will consider any appropriate next steps, including the use of our enforcement powers.”
