Exploring the Art of Occupation

I’ve been thinking about this ruling throughout the bank holiday weekend. Like many, I’ve been sitting with a mixture of frustration, sadness, and deep concern of real hurt and damage this causes to a community that already faces disproportionate injustice and exclusion.

Writing blogs is an occupation I engage in to help me make sense of complex issues. It’s how I process, reflect, and try to move forward with clarity. This blog is part of that process and it’s written with care, with compassion, and in solidarity.

What happened

On 16 April 2025, the UK Supreme Court ruled that, under the Equality Act 2010, the words “woman” and “sex” refer to biological sex as assigned at birth (Supreme Court, 2025). The decision has prompted widespread public discussion, concern, and understandably distress, especially among trans and non-binary communities.

In the days that followed, many took to social media, news platforms, and mainstream media to comment on the ruling. While some praised the court’s clarification, others voiced strong opposition highlighting the real-world impact on trans people’s safety, identity, and dignity. Peaceful protests have taken place in several cities, but distressingly, there have also been reports of a rise in online abuse and public hostility. For example, in Edinburgh, a protest outside the Scottish Parliament was met with counter-demonstrations, and several trans rights campaigners reported being targeted online with hate speech (BBC News, 2025).

As an occupational therapist and someone committed to inclusion, I cannot remain silent when legal rulings risk deepening occupational injustice. This blog reflects on what this judgment means, not from a legal standpoint alone, but through the lens of what truly matters to people: their right to live, engage, and participate fully in life, in ways that reflect who they are.

What Did the Court Rule?

The case involved the charity For Women Scotland, which challenged the Scottish Government’s guidance that allowed trans women with Gender Recognition Certificates (GRCS) to be counted as women in legislation. The Supreme Court ruled unanimously that, for the Equality Act, the protected characteristic of “sex” refers to a person’s sex as assigned at birth (UK Supreme Court, 2025). This effectively excludes trans women from single-sex spaces intended exclusively for biological females.

However, it is essential to note that this ruling does not remove the protected characteristic of “gender reassignment” under the Equality Act (Equality and Human Rights Commission, 2024). Discrimination based on gender reassignment remains unlawful.

Why Occupational Therapists Should Care

Some might argue that legal decisions like this are outside the scope of occupational therapy. But that ignores something central to our profession: occupation is political. People’s ability to engage in meaningful roles and activities is shaped by policy, social norms, and laws. When the law reinforces exclusion or reduces identity to rigid definitions, it creates occupational injustice (Townsend and Wilcock, 2004).

1. Occupation is Gendered

Gender identity influences how people experience their daily occupations from employment and education to leisure, personal care, and social roles (Creek, 2010). Trans and non-binary individuals often face barriers to engaging in meaningful activities due to discrimination, stigma, or fear. These barriers can lead to occupational deprivation, a well-documented determinant of health inequity (Townsend & Wilcock, 2004).

2. Therapeutic Relationships Require Trust

The therapeutic alliance is built on trust, safety, and mutual respect. If a service, policy, or system invalidates a person’s gender identity, it risks undermining that trust. When individuals cannot bring their whole selves into the therapeutic space, outcomes are compromised.

3. We Must Resist Occupational Injustice

As occupational therapists, we must actively challenge injustice. The Royal College of Occupational Therapists (RCOT, 2021) calls on the profession to promote equity, anti-discrimination, and inclusive practice. Upholding these values means advocating for trans rights, not just through words, but through service delivery, policy influence, and personal accountability.

As a profession, we talk a lot about “inclusion” and “belonging”, but these can’t be hollow words. Legal decisions like this require us to ask: Who is being left out? Whose occupations are being limited? And what can we do to challenge that?

It is not enough to be non-discriminatory; we must be actively inclusive. That means educating ourselves, standing up for trans clients and colleagues, and pushing our professional bodies, services, and employers to ensure gender diversity is respected and affirmed.

Anticipating the Debate

Some may feel this blog is too political or that it dismisses the rights of women. Others may view it as performative or feel that it doesn’t go far enough. These are fair challenges, and they deserve thoughtful responses.

To be clear: supporting trans rights does not undermine women’s rights. These are not mutually exclusive aims. As an intersectional feminist, I believe that gender equality must include all women, cisgender, transgender, and non-binary people whose experiences are shaped by patriarchal systems. Liberation that excludes some is not liberation at all.

Occupational therapy must be rooted in solidarity, compassion, and justice, not division. Inclusion is not a zero-sum game; it enriches our collective practice and ensures we deliver safe, affirming care for all.

And yes, this blog does not centre trans voices, but it aims to amplify their right to be heard, respected, and included.

What Can We Do?

• Educate ourselves on gender identity, inclusive language, and cultural safety.
• Ensure our services are welcoming and affirming to all clients and staff
• Challenge policies and practices that exclude or erase gender-diverse people
• Listen to and platform trans colleagues and service users
• Commit to ongoing reflection, allyship, and accountability in our practice

Conclusion

Occupational therapy is not neutral. It is a profession that engages directly with the social world and the structural barriers people face. The Supreme Court ruling may clarify certain legal definitions, but it cannot and must not define the scope of our compassion, ethics, or responsibility to others.

This is our moment to choose inclusion, to advocate fiercely for participation without condition, and to ensure that occupational therapy remains a place where everyone belongs.

References

BBC News (2025) Trans rights activists protest outside Scottish Parliament after Supreme Court ruling. Available at: https://www.bbc.co.uk/news/uk-scotland-xx-xx (Accessed: 21 April 2025)

Creek, J. (2010). The Core Concepts of Occupational Therapy: A Dynamic Framework for Practice. London: Jessica Kingsley Publishers.

Equality Act 2010. (c.15) Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents (Accessed: 21 April 2025).

Pollard, N., Sakellariou, D. and Kronenberg, F. (2010) A Political Practice of Occupational Therapy. London: Churchill Livingstone.

Royal College of Occupational Therapists (2021) Position Statement: Anti-Racism and Occupational Therapy. London: RCOT.

Supreme Court (2025) For Women Scotland Ltd (Appellant) v The Lord Advocate and another (Respondents) [2025] UKSC 18. Available at: https://www.supremecourt.uk/cases/uksc-2023-0110.html (Accessed: 21 April 2025).

Townsend, E. and Wilcock, A. (2004) ‘Occupational justice and client-centred practice: A dialogue in progress’, Canadian Journal of Occupational Therapy, 71(2), pp. 75–87.

Wilcock, A.A. and Hocking, C. (2015) An Occupational Perspective of Health, 3rd edn. Thorofare, NJ: SLACK Incorporated.