An employment tribunal has ruled that nurse Sandie Peggie was harassed by NHS Fife - but dismissed all other claims in her case.

In a written judgment on Monday, the tribunal found that NHS Fife had harassed Ms Peggie in a number of ways:

• It said that when she complained to her employers about Dr Beth Upton using the women's changing rooms permission should have been revoked on an interim basis. It said the NHS should have stopped allowing Dr Upton to use the changing rooms until different work rotas took effect - at which point they wouldn't still be working together.
• The tribunal also ruled that the health board had taken an unreasonable time to investigate the claims against Ms Peggie - and that officials were wrong to tell her not to discuss the case.
• The health board making reference to unproven claims that Ms Peggie had put patients at risk were also deemed to amount to harassment.
• But Ms Peggie's claims of discrimination and victimisation by NHS Fife did not succeed and were dismissed.
• The tribunal also dismissed the claims which were made against Dr Upton.
• A separate hearing will take place later to decide on the "remedy" for Ms Peggie, which could result in her being awarded compensation.
• Ms Peggie welcomed the judgement and said the past two years had been agonising.
• NHS Fife said it would take time to work through the details, while First Minister John Swinney said his government would look at the "general issues to be learned".

The most high-profile tribunal finding since Supreme Court rulingpublished at 17:37 GMT 8 December 2025

17:37 GMT 8 December 2025

Alison Holt
Social affairs editor

A lot of people will be poring over the details contained in the lengthy Sandie Peggie finding to see what it might tell us about how equality law should work in practical terms.

Although this case started nearly two years ago, it is the most high-profile tribunal finding since April when the Supreme Court sought to bring clarity to arguments where the rights of women and the rights of transgender people are in conflict.

The highest court in the land ruled, external under equality law the term “sex” means biological sex, and that a trans woman is a biological man who identifies as a woman. It also said if a space was designated as single sex, such as a changing room, then it was for people of the same biological sex, or it ceased to be single sex.

The government is currently considering guidance from the Equality and Human Rights Commission (EHRC) which sets out what that means for employers, like the NHS, and services on a day-to-day basis.

So, in the gap that is left, tribunals like Sandie Peggie’s become way markers – they give us a sense of the direction of travel on these difficult issues.

Discrimination lawyer Robin Moira White works with Translucent, a trans-led advocacy and human rights organisation.

She says the tribunal ruling was a "very sensible, balanced judgement".

Ms White adds: "It recognised that both trans people and gender critical people have rights in the workplace and employers have to balance those."

She says blanket exclusion or blanket inclusion are unlikely to be lawful and that the ruling found Sandie Peggie had harassed Dr Upton, not the other way around.

"This is showing trans people need to be accomodated appropriately in workplaces, be it toilets or be it changing rooms, and that can only be to the good."

The campaign group Sex Matters, which backed Sandie Peggie in the case, said it was very disappointed in the approach taken by the tribunal.

Maya Forstater, the organisation's CEO, said the panel tried to strike what she called "a spurious balance" with its ruling.

She said the tribunal should have provided employers with clarity regarding single-sex spaces - and that should have meant giving them the confidence to refuse to let trans women use those spaces.

"It is a travesty that a woman can be judged as having expressed herself in the wrong way when she objects to finding a man in the women’s changing room," she added.

Ms Forstater said there was an "urgent" need for the Health and Safety Executive to provide clear guidance to employers regarding workplace toilets and changing rooms.

A recurring issue during the tribunal was whether women were at greater risk from transgender women being given access to single-sex spaces.

Sandie Peggie said she felt intimidated when Dr Upton was using the changing rooms in the Victoria Hospital.

However, the tribunal panel has said it does not feel trans women are more of a risk.

It stated: "Having read all of the documents, there is very far from sufficient reliable evidence to establish as a fact that a trans woman who is legally and biologically male is a greater risk to any person assigned female at birth within a changing room environment at a workplace than another woman assigned female at birth."

Scottish Greens co-leader Ross Greer has told BBC News he believes NHS Fife handled this case "incredibly poorly".

"The allegations of harassment made against Dr Upton were not upheld," Greer says.

"Beth Upton was just a doctor trying to do her job and support her patients.

"She has been dragged through this horrendous, invasive process for no good reason."

He says this is a reminder of how "horrible, how hostile it is for trans people in our society now".

We've not heard the last of Sandie Peggiepublished at 16:30 GMT 8 December 2025

16:30 GMT 8 December 2025

David Henderson
BBC Scotland Correspondent

This ruling is just the first of Sandie Peggie’s legal battles.

She has significant backing. So she's taking forward three more court cases against people she thinks have treated her badly.

She is suing NHS Fife health board, its chief executive and its head of “people & culture”. She’s trying to push the health board to confirm they will exclude transgender women from female single-sex changing rooms – which she claims is yet to happen.

In a separate case she's suing three of the senior medical staff who gave evidence in her case, and the health board – again.

She’s also suing her trade union, the Royal College of Nursing, claiming it failed to protect her and help her, when she was suspended. That's something they deny.

So what impact might that have on the broader trade union movement?

Might it force other trade unions to be more understanding of so-called "gender critical" views - that sex is biological and people cannot change sex?

There's a lot at stake. And it's clear we've not heard the last of Sandie Peggie.

In its judgement, the tribunal examined the incident which took place in the changing room on Christmas Eve 2023 involving Sandie Peggie and Dr Beth Upton.

It says some of Ms Peggie's comments towards Dr Upton "amounted to an incident of harassment" and breached the health board's bullying and harassment policy.

The events on Christmas Eve have been disputed, but the tribunal says that the evidence of Dr Upton should be preferred. It describes the doctor as a more credible witness, and says Ms Peggie questioned Dr Upton in a "intrusive and confrontational" way.

It says Ms Peggie questioning Dr Upton about chromosomes was "a clear invasion of privacy".

There was also a dispute over the intent of a comment where Ms Peggie said Dr Upton's presence "was just like that person in the prisons". This was taken to be a reference to rapist Isla Bryson, who changed gender while waiting to stand trial.

Ms Peggie said in her evidence that she was not aware the case involved a rapist, but the panel said that claim was not credible.

The tribnual also said its conclusion that Ms Peggie's actions amounted to harassment was different to the outcome of a disciplinary hearing, which ruled that there was not enough evidence to uphold the harassment complaint.

As we've been reporting, the tribunal partially found in Sandie Peggie's favour.

It ruled that the health board should have paused Dr Beth Upton's permission to use the women's changing rooms after Sandie Peggie complained in autumn 2023, saying it would have been a temporary decision "pending a more long-term solution being found".

The verdict notes this would have been a "difficult balancing exercise" but that NHS Fife did not meet it.

It also found NHS Fife took too long to investigate the claims against the nurse, after initially suspending her at the start of January 2024.

The verdict ruled references to concerns over patient care as being a reason for Ms Peggie's suspension - which the nurse learned about on 28 March - were "not fundamentally ones of patient care".

The ruling states that there was no direct evidence to establish patient care was adversely affected by Ms Peggie's gender-critical beliefs, and notes two reported issues - which included claims the nurse left a patient in a cubicle due to Dr Upton's presence - were not raised contemporaneously.

It states it was "not clear why there was a formal allegation as to patient care, rather than as one of not interacting with a trans woman".

The last issue it finds in favour of Ms Peggie is that she was told by NHS Fife not to discuss the case, only to then be told two weeks later this only applied to the actual investigation itself, which was ongoing at that point.

The tribunal dismissed the other allegations against the health board and all claims against Dr Upton.

What impact will this ruling have?published at 15:50 GMT 8 December 2025

15:50 GMT 8 December 2025

David Henderson
BBC Scotland correspondent

This ruling suggests employers will have to be even-handed in the way they deal with cases like this in future.

We now know that Sandie Peggie was entitled to complain in a reasonable way, when she found herself sharing a changing room with a transgender colleague.

It wasn't necessarily instantly bigoted, or illegal, or a sacking offence to speak out, as some senior colleagues at NHS Fife seemed to think.

Instead, she was entitled to complain to her manager - and at that point action should have been taken to reflect her concerns.

According to the tribunal, the law says that it is neither legal OR illegal for a transgender woman to use female changing rooms.

It only becomes an issue - as in this case - when a complaint is made.

The ruling also makes clear that what followed Sandie Peggie's suspension was unfair and unjust.

She was harassed by NHS Fife health board.

Bosses across the UK will take heed of today's ruling.

They know they can't immediately take sides - even if they want to.

Instead, they will have to strike a balance to ensure everyone's rights are respected.

Scottish Conservative equalities spokesperson Tess White has given her reaction to the tribunal's ruling.

She says NHS Fife "shamefully tried to silence a nurse who stood up for women’s rights, then squandered a fortune of taxpayers’ money defending their harassment of her".

She says the health board has serious questions to answer, as do John Swinney and Neil Gray - who she says backed the management team "at every turn".

Ms White calls on the first minister to apologise and describes the SNP's approach as a "shameful saga" stemming from "the SNP imposing their reckless gender self-ID policy".

This was a case where even the descriptions and names people use were controversial.

The judge was conscious of this in his ruling. In a section on terminology, he explains that the different sides of the case preferred to use different pronouns to describe Dr Beth Upton, who is a transgender woman - that is, a biological male who identifies as a woman.

This meant that during cross-examination, one side would use male pronouns (he/him) and the other female pronouns (she/her).

The ruling tries to avoid this, saying judges "need to be careful not to let the choice of gendered pronouns give an appearance of bias".

A partial - and rather narrow - victory for Sandie Peggiepublished at 14:51 GMT 8 December 2025

14:51 GMT 8 December 2025

David Henderson
BBC Scotland correspondent

I'm working my way through this 312-page judgement and it’s pretty complex stuff. But the upshot is clear - Sandie Peggie can claim a partial - and rather narrow - victory.

The tribunal ruled the health board harassed her in a number of ways. When she complained to her employers about Dr Beth Upton - a trans woman - using the women's changing rooms, the tribunal found health managers should have acted differently.

The NHS should, it says, have stopped allowing Dr Upton to use those changing rooms until different work rotas took effect - at which point they wouldn't still be working together. After she was suspended, the health board took months to investigate the allegations against her. This was an "unreasonable time".

When Ms Peggie first learned in March 2024 - months after her suspension - of unproven claims that she'd put patients at risk, this too amounted to harassment. And at one point she was instructed not to discuss the case at all - although later this order was relaxed to apply only to the investigation. This, says the tribunal, was harassment.

She has not succeeded in the other legal claims she made, against Dr Upton and against NHS Fife, but Sandie Peggie is likely to see this as a win. She took on her employers, hauled them through the courts, and proved their treatment of her was unfair.

It will surely mean big changes to how employers have to act.

NHS Fife and Dr Upton were represented by the same legal team.

They argued that Beth Upton “is a human being who is just doing a job" and had been drawn into this difficult legislation despite having permission to be in the female changing room.

Part of their case was that Dr Upton was following the European Human Rights code of practice at the time - which said people should use facilities matching their acquired gender.

Part of the NHS Fife argument is the so-called Bananarama defence, named after the pop group's 80s hit, It Ain’t What You Do, It’s the Way That You Do It. They argue the way Sandie Peggie treated Dr Upton and expressed her gender critical beliefs was inappropriate.

They questioned why Sandie Peggie did not raise the issue with management or her trade union before the Christmas Eve encounter, and said the altercation had been started by Ms Peggie.

NHS Fife said removing Ms Peggie from from the work was standard practice in bullying and harassment cases, and none of the events following Christmas Eve were the result of the nurse having gender critical beliefs, but an "inevitable consequence" of how she spoke to Dr Upton.

Image source, Getty Images

Sandie Peggie argued Dr Beth Upton is a man and should not have been allowed to use a female changing room to undress.

Her lawyers used case law (Corbett, Bellinger and FWS) to argue Dr Upton is a person the Supreme Court considers male, and that is the doctor’s sex for the purposes of the Equality Act.

Ms Peggie argued she is entitled to a female-only changing space and that she has a right not to suffer harassment under the Equality Act 2010. Her legal team said Dr Upton's presence amounted to unwanted conduct related to sex that was humiliating for Ms Peggie.

They also argued allowing a man to use the women’s changing room converts single-sex space into mixed-sex space in which females experience the detriment.

Sandie Peggie’s lawyers also claimed an “unjustified disciplinary process” by NHS Fife constituted harassment and that its purpose was to punish the nurse for expressing gender critical beliefs.

Image source, Getty Images

Scotland’s first minister says the tribunal ruling in “this complex case” is important and that his government will look at the “general issues to be learned”.

John Swinney told BBC News: “It is important to take time to consider the judgement, that is the role of NHS Fife to do so, and of course the Scottish government will consider any issues that arise out of the judgement for the taking forward of public policy in this area.”

Asked whether he thought nurse Sandie Peggie was right to raise the case, Swinney said that “individuals with concerns about their employment practice are free within the law to raise any concerns that they have”.

As we continue to go through the details of the ruling, here's a reminder of why NHS Fife insisted there were two reasons to suspend Sandie Peggie.

The first was to avoid a repeat confrontation with Dr Upton and the second was to ensure patient safety.

The patient safety allegations involved two separate incidents where Dr Upton claimed Ms Peggie’s conduct was a concern when treating patients.

These included leaving a patient in a cubicle due to Dr Upton's presence - a claim vehemently denied by the nurse.

Her legal team said no reference had been made regarding patient safety concerns when the nurse was suspended on 3 January 2023. They claim the first time she was aware of them was in an email sent on 28 March - during discussions on her return to work. During the tribunal, her legal team questioned why Dr Upton had not raised concerns at the time.

The health board said any suspension would be based on a risk assessment, but did not submit any documents for that as evidence during the tribunal.

Ms Peggie's return to work was agreed on 2 April, and her first shift back was 13 April.

A key point of the ruling takes into account the recent UK Supreme Court decision that a woman is defined by biological sex under equalities law.

However, the tribunal said that this decision did not make it inherently unlawful for a trans female, who is biologically male under the act, to be given permission to use a female changing room at work. Neither did it say it was inherently lawful. Instead it said a range of factors should be looked at.

Some of Sandie Peggie's claims of harassment by NHS Fife did succeed so there will need to be a further hearing to decide on the legal remedy.

The possible remedies for the losing party in an employment tribunal can range from paying compensation to covering witness expenses.

The main remedy would likely be for injury to feelings - a specific remedy with guidelines known as the Vento Bands used to determine compensation amounts.

Payments start at £1,200 for less serious cases and rise to £60,700 for the most serious - but even those can be exceeded for "exceptional cases".

The tribunal ruling only addressed the issue of whether Ms Peggie was harassed by NHS Fife.

It found harassment on some of the specific claims but dismissed other claims of discrimination and victimisation.

There will now need to be a separate hearing to assess what "remedy" should be granted to her for the harassment that was found.

It will be fixed for a later date.