Equality Act 2010 Guidance: Gynaecological Conditions

Debate between Christine Jardine and Tulip Siddiq

Tuesday 3rd November 2026 Westminster Hall

[Tulip Siddiq]

I am pleased to see the hon. Member attend every debate in the Chamber; he has not stopped doing that and he is always fighting for the rights of women in any of the debates that we have. He is right to say that we do need to settle what is happening in the workplace, but we also have to look at the healthcare system as well and make sure that it does not become a postcode lottery where women have to travel in order to get treatments that should be available for everyone.

In response to my constituent’s petition, the Government acknowledged that such conditions can affect women’s performance at work, but said they had no plans to amend the guidance. That is why I am standing here today, urging my colleagues in the Government to reconsider that decision. When a woman’s condition is missing from the guidance, she starts every conversation with her employer and the human resources department, as well as every claim, on the back foot. That is because courts and tribunals must take the guidance into account. HR departments and managers will use it as their checklist. It opens the door to legal protection, fairer workplace adjustments and a fairer system for millions of women across the country.

Last month, hon. Members may have seen that the all-party parliamentary group on endometriosis published its “Endometriosis (Not) in the Workplace” report. The results were sobering. Evidence was gathered from more than 6,000 employees with confirmed or suspected endometriosis, and from 250 employers. The inquiry provides one of the most detailed pictures yet of the condition’s impact on working life. These are some of the facts: 97% of employees worked with severe pain; 94% believed employers lacked understanding of the condition; 62% were worried about losing their job; 47% had lost income and 39% were experiencing financial hardship; 49% had difficulties progressing in their career after the condition; 28% had been forced to leave their job altogether; 49% had received no workplace adjustments at all; and 72% of employers said they had no training or guidance on women’s health conditions, such as endometriosis.

It is fair to say that women with endometriosis have been failed by the employment rights system. It is damaging their lives, their families and the economy. With only 11% of employers in the UK having a menstrual health policy, employers are not making the reasonable adjustments to accommodate people with endometriosis, who are forced to suffer in silence. That shocking statistic highlights why there is such widespread discrimination of women with endometriosis. That is why gynaecological conditions must be included as impairments with fluctuating or recurring effects in the Equality Act 2010 guidance on the definition of disability. By doing that, we will strengthen workplace protections for women with disabling gynaecological conditions, including endometriosis, fibroids, PMOS, PMDD, severe menopausal symptoms and other menstrual disorders.

One of the biggest challenges we have—I have learned a lot of this from my constituent who suffers from this issue—is the unpredictable nature of those conditions. Women can experience severe pelvic pain, debilitating fatigue, heavy bleeding that leads to anaemia, bowel and bladder symptoms, bloating, nausea, loss of appetite and other complications that can fluctuate in severity. For example, a woman with endometriosis may be able to function absolutely fine one day, but the next day cannot get up from her bed. Employers should take that into account. It is overwhelmingly evidenced in medical statistics, but my constituent tells me it is being ignored by employers because the conditions are not listed in the guidance, which is what we are fighting for.

I ask the Minister, who I know is passionate about this topic and has been in touch with me about it, to consider four practical steps. First, will she update the Equality Act 2010 guidance? It is issued by a Minister under section 6 of the Act, so no primary legislation is needed. Gynaecological conditions should be named among the examples of conditions that have recurring or fluctuating effects. The guidance should include worked examples of what a flare can look like in a working day, and it should discuss pain that stops a woman travelling, standing up or concentrating, heavy bleeding, fatigue, anaemia and recovery from surgery.

Secondly, will the Minister look at the Equality and Human Rights Commission guidance and set out in the employment code examples of reasonable adjustments for such conditions, such as flexible and hybrid working, adjusted hours on bad days, access to facilities and rest breaks, time off for medical conditions and a phased return from surgery? It is incredible that women have to fight for those things—of course they should have a phased return after surgery, but lots of women do not have that option in the workplace. A lot of those things would cost little or nothing, but they would make the lives of those who are suffering so much easier.

Thirdly, I ask the Minister to give employees something tangible to take back to their managers or to human resources. A simple standard workplace adjustments passport, backed by ACAS guidance, would record what has been agreed so that the woman does not have to explain her condition over and over again every time her manager changes, which is exhausting in itself, and the managers know exactly what is expected of them.

Fourthly, I would build on the Employment Rights Act 2025. Large employers will soon have to publish equality action plans that include support for employees who are going through the menopause. The plans should extend to menstrual and gynaecological health. The Government’s Keep Britain Working agenda and their workplace health system should expressly include women with long-term fluctuating conditions.

Those changes would help not only women with such conditions but everyone living with a non-visible chronic condition whose effects come and go. Those basic changes could save jobs and so much money, and relieve so much anxiety for countless women across the county who are disabled by endometriosis and are not given reasonable adjustments in the workplace. By doing that, we can be a Government who ensure women have workplace protections and the right to reasonable adjustments for their conditions.

As the Minister knows, I was a part of the Treasury, so the economy is always on my mind. This is not just a question of fairness; it is actually about a strong economy and sound business. Endometriosis alone is estimated to cost the UK economy £8.2 billion a year in treatment, lost work and healthcare costs. The Office for National Statistics found that women with endometriosis earned about £4,500 less over the five years after receiving a diagnosis. The Fawcett Society found that one in 10 women who worked during the menopause left their job because of their symptoms, and many others worked on reduced hours.

The PMDD Project found that nine in 10 reported that PMDD significantly or extremely affected their everyday lives—particularly employment. They can be perceived as unreliable, inconsistent or unable to manage their workload, when in reality they are living with a recognised and often severely disabling condition. I am sure the Minister agrees that women are a vital part of our workflows and our economy. It is right that the law and guidance explain that and reflect the reality of their everyday lives.

Employment lawyers acting in such cases describe the same pattern again and again. Very senior women, in whom businesses have invested year after year through training and client development, are managed out after surgery or a period of sickness absence, when a phased return, a flexible pattern of working or a modest change to their duties could have retained them and helped our economy at the same time. The business loses the woman’s skills, client relationships and everything that has been invested in them. It then pays to recruit and train a replacement, and it very often pays again to defend a claim. Claims can take years. At the end of June this year, there were 70,000 claims waiting in employment tribunals—the highest number on record.

The average claim takes well over a year to resolve, with some final hearings being listed for 2028 and 2029. With appeals, a case can run for three years or more. Think about the damage that does to the economy, the business and particularly the morale of all our women who we need back in our economy working for our country. It is three years of legal costs for both the employer and former employee. It is three years of uncertainty and anxiety for all the women, and three years in which neither the business nor the woman can move. That cripples the economy, the business and, often, the woman’s life.

The cases that do reach the courts show what is at stake. In South Gloucestershire council v. Hundal, which was decided by the employment appeal tribunal in 2024, a social worker with endometriosis—who the tribunal found was managing complex cases well despite her disability—had her placement ended because of the absences caused by her medical condition. Her manager had suggested adjustments such as working from home and spreading her four-day week over five days. Neither of those was tried and an occupational health referral was not even considered. The tribunal found that ending her engagement could not be justified and an appeal tribunal agreed.

In another case, a tribunal accepted that a woman with endometriosis could not walk, stand or drive when her systems flared. The condition left her anaemic, exhausted and unable to sleep. It found that she was disabled, observing that nothing in the Equality Act requires a disability to be constant. That is exactly why guidance should be made plain: so that women do not have to waste time, effort and mental energy going to a tribunal to establish it.

Reasonable adjustments are the most effective way to avoid all this. They keep women in work, protect the employer’s investment and stop claims arising in the first place. Prevention is far cheaper than cure. For as long as our employment rights ignore the gynaecological conditions of millions of women in Britain, the injustice will continue. Making reasonable adjustments is simply the fairest thing to do. It is also the most sensible thing to do economically. Naming these conditions in the guidance would give every woman something concrete to point to, and every employer a clear basis on which to act. It would save money and time, and most importantly it would spare women, their families and their employers so much avoidable pain.

The benefits of doing that spread beyond the workplace, to all of us in society. It will improve the mental health and wellbeing of women by enabling them to be seen, heard and protected, and to advocate for themselves. The guidance will also help Department for Work and Pensions assessors, who are rejecting claims from women with endometriosis and other gynaecological conditions. For me, that is a win-win because it will protect women in the economy, education, healthcare, the workplace and beyond. I urge colleagues in Government to recognise what women experience every single day. I believe it is time to end this discrimination once and for all.

[Christine Jardine (in the Chair)]

I remind Members that they should bob if they wish to be called.