NHS staff have been told they can use the pronouns 'Xey/Xem' at work as part of a plan to boost 'inclusion in the workplace'.
The gender-neutral pronouns - often used within nonbinary and trans communities - can be used as alternatives to I/me, She/her, He/him, They/them, Ze/Zir or It/Its depending on the colleague's preference.
King's College Hospital NHS Foundation Trust in south London also told staff they should apologise if they accidentally use the 'wrong' pronouns.
The trust said it was each person's responsibility to 'identify what their pronouns are', explaining the aim was to 'create an inclusive environment and demonstrate inclusion in the workplace'.
And if pronouns 'aren't important to you', the trust added, it is 'even more important to use them'.
The training presentation, from February last year, also encouraged employees to correct others if they hear them using the wrong pronouns to address someone.
The trust also urged workers to use gender-neutral language - including sibling instead of brother or sister, and team or folks instead of ladies and gentleman.
Women's rights groups have condemned the presentation, branding it 'virtue-signalling which could affect patients'.
Fiona McAnena, director of sex-based rights charity Sex Matters, said the guidance was a 'ridiculous distraction for NHS staff'
The presentation came before the landmark Supreme Court ruling which happened last year, which stated the definition of a woman was determined by biological sex.
Fiona McAnena, director of sex-based rights charity Sex Matters, told the Telegraph: 'This is enforced speech and a ridiculous distraction for NHS staff. This isn't just harmless virtue-signalling – it could put patients at risk.
'Clinicians need to be free to refer to people as male or female. Often, it is medically necessary.
'But instead of focusing on the right care for the patients, NHS staff are being told they have to adopt meaningless words like 'xie' and 'xir', and to apologise if they get it wrong.'
The presentation came to light after Christian NHS nurse Jennifer Melle, 41, was suspended after she referred to a transgender paedophile patient as 'Mr'.
Ms Melle was forced out of St Helier Hospital in Carshalton, Surrey, in May 2024 after a 6ft male sex offender with a beard objected to the masculine title.
During the incident, Ms Melle was subjected to screaming racist abuse and threats of violence from the patient.
Nurse Jennifer Melle (pictured) was suspended after she referred to a transgender paedophile patient who identifies as a women as 'Mr'
She was then accused of a potential patient data breach by Epsom and St Helier University Hospitals NHS Trust for speaking about the incident - despite the person's identity remaining unknown.
She was suspended, disciplined, and finally reinstated after public outcry and protests by groups including the Darlington nurses - who won their case against an NHS hospital that allowed a male-born colleague to use women's changing rooms.
Today, single mother-of-two Ms Melle is set to return to hospital to work alongside her colleagues on the frontline.
She told the Daily Express: 'While I am glad to be returning to work, I must be honest: this is not over.
'For nearly a year I have been suspended simply for telling the truth: that I was racially abused and physically threatened after using biologically accurate language to refer to a male patient. I was treated as the criminal.'
In the freedom of information request seen by The Telegraph, representatives for King's College Hospital NHS Foundation Trust said: 'This training pre-dates the Supreme Court ruling. It is not specific to the updated interpretation of the law and is instead designed to help differentiate the difference in terminology used between sex and gender.'
A King's College Hospital NHS Foundation Trust spokesperson said: 'Our aim is to ensure our hospitals are welcoming and safe environments for everyone, where individuals feel respected and able to access the care they need at all times.'
