Labour has been accused of "indefensible" delays by sitting on guidance aimed at stamping out "radical gender ideology". Pressure is mounting on the Government to publish in full recommendations to end "absurd witch hunts" in the wake of three landmark legal cases in which the NHS was defeated.
The public sector - which employs more than 6 million people in the UK - was told to adhere to the law immediately after the Supreme Court ruled in April last year that a woman was defined by biological sex.
Yet almost 10 months later, fury is growing because there has been no progress.
Andrea Williams, Chief Executive of the Christian Legal Centre, said: "The Government's continued delay in publishing lawful guidance on singlesex spaces is now indefensible.
"Every further delay fuels confusion, enables injustice, and exposes nurses to disciplinary action simply for upholding biological reality or acting according to conscience. Guidance must be published without delay so that the NHS and other public institutions can finally operate within the law and protect their staff from further harm."
Last week, Jennifer Melle, 40, a nurse suspended after "misgendering" a transgender paedophile patient, was reinstated after Epsom and St Helier University Hospitals NHS Trust was forced into a humiliating climbdown in the face of public anger.
Her case followed victories for seven nurses in a legal fight against County Durham and Darlington NHS Trust, which allowed a biological male trans woman to undress in front of them, and Scottish nurse Sandie Peggie, who was suspended by NHS Fife after complaining about having to share a changing room with transgender medic.
Mrs Williams said: "The Supreme Court has ruled, the law is clear, and the consequences of inaction are no longer hypothetical.
"The vindication of Sandie, the Darlington nurses, and Jennifer has demonstrated, time and again, that the absence of clear, lawful guidance has left public bodies acting unlawfully and staff placed at risk. There are no excuses left."
An updated code of practice drawn up by the Equality and Human Rights Commission was passed to Bridget Phillipson, Minister for Women and Equalities, on September 4.
One month later, it wrote to her demanding she bring it to Parliament as soon as possible.
Yet in spite of the trio of judgements in favour of women who fought for legal protection - and won - the Government has been accused of dragging its heels.
Failure to act means individual NHS trusts can still allow biological men identifying as women to use female changing rooms.
After Ms Melle's victory, Tory party leader Kemi Badenoch said: "I am delighted that common sense has prevailed. But it is not justice.
"Jennifer has been dragged through the mire for two long years. And for what?
"Radical gender ideology that makes a mockery of the law. The Government must act to end these absurd witch hunts."
In a landmark ruling, the Supreme Court clarified the law, holding that biological sex is unchangeable under the Equality Act, which provides workplace protections.
But the NHS, Europe's biggest single employer, and the wider public sector remain mired in chaos and confusion over how the law should be interpreted and implemented.
The EHRC was forced to undertake a major update of the existing code of practice - first published in 2011 - to reflect significant developments in legislation and case law including the threshold for a philosophical belief to be protected and, most significantly, the Supreme Court judgment on the definition of sex.
It said: "We have been clear that service providers, associations and public functions should not wait for the code of practice to be published to make any changes needed to comply with the law. As duty-bearers, they must assure themselves of their legal responsibilities in their own specific circumstances and seek independent legal advice where necessary."
Supporters of the nurses include author and activist JK Rowling who said: "If some trans-identified people in the UK are experiencing rage and disappointment because the Supreme Court clarified that they don't have rights they believed they had, the responsibility lies firmly with [those] who've persistently argued, falsely, that gender transition turned a person into the opposite sex for all practical purposes in the eyes of the law."
The updated code of practice must be laid before Parliament for 40 days before it can become statutory guidance.
Maya Forstater, boss of charity Sex Matters, said: "Jennifer never should have been in trouble at work for calling a man 'he'. She was hung out to dry by her employer and her union, both of which seem to think the feelings of a paedophile mattered more than biological reality.
"Everyone who heard her story was appalled by how she was treated. Health Secretary Wes Streeting needs to get a grip on this and stop the transgender obsession that is corrupting the NHS."
A Government spokesperson said: "The EHRC has submitted a draft Code of Practice to Ministers and we are working at pace to review it with the care it deserves.
"This is a 300-page-long and legally complex document, and it is important for service providers that we get this right. It would be catastrophic for single-sex services to follow guidance that wasn't legally robust and then place them in legal jeopardy again.
"That is why it is vital we get this right.
"We have always been clear that the proper process needs to be followed, and we are following it."
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