As evidence sessions drew to a close in Sandie Peggie’s employment tribunal against NHS Fife, supporters applauded the ER nurse for standing tall through a “stitch-up” counter-offensive from the health board likened to a “witch hunt”.

The Victoria Hospital emergency room nurse of 30 years was locked in a fierce lawsuit over her treatment after she objected to sharing a changing room with the transgender female doctor, Beth Upton, which resulted in her suspension and an investigation into her alleged behaviour and patient care failings.

After sitting through more than 120 hours of testimony, Sandie Peggie stepped out of the Dundee Tribunal Hearing Centre on July 29 to rapturous applause from friends and family, women’s rights campaigners and supportive strangers.

Adding to the applause were members of For Women Scotland, a frequent presence at the nurse’s side since she first brought the case due to its link to the Supreme Court victory over the Scottish Government in April.

This spring, three judges unanimously agreed “sex”, “man” and “woman” refer to biological sex assigned at birth for the purposes of the Equality Act 2010 and Peggie’s case was built on NHS Fife’s handling of the emergency room nurse’s objections to sharing a single sex space with Dr Beth Upton.

Sandie Peggie’s workplace conflicts started in August 2023 when she raised concerns with her line manager after first encountering Beth Upton in the female changing room at NHS Fife’s Victoria Hospital.

A second incident occurred in the late autumn - again reported to her line manager - before tensions turned into changing room hostilities on Christmas Eve, where Dr Upton walked in on Peggie managing her period.

Upton accused Peggie of comparing her arrival to the presence of transgender rapist Isla Bryson, which vexed the doctor into reporting her for bullying and harassment, causing NHS Fife to log a “hate incident”.

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Peggie denies making the comparison, instead collating the incident to “men being in women’s prison” and claimed she did not know Isla Bryson - formerly Adam Graham - was a rapist.

Peggie was placed on special leave while the health board doubled down on an investigation into her alleged misconduct, failure of patient care and misgendering Upton.

Nearly 18 months later, in the evening before the first session of the second hearing block, NHS Fife announced the conclusion of their investigation cleared the nurse of wrongdoing but by this time, Peggie and her legal team had poured more than a year into her case claiming for sexual harassment, belief discrimination and victimisation.

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Nearing the February 3 start date, bids by NHS Fife and Dr Upton for private hearings and preserving Dr Upton’s anonymity were swiftly rejected.

Employment Judge Antoine Tinnion highlighted, “Potential public scrutiny of a witness’s evidence is an important part of the open justice principle,” adding it “provides an important incentive to give honest, truthful evidence.”

During the first ten-day hearing block, Peggie testified she “felt more shocked than anything” at Dr Upton’s formal complaints.

She said: “I told Beth I felt it was unacceptable that he was in the female changing area,” but later acknowledged misgendering Upton was then considered harassment under NHS guidelines.

Jane Russell KC, representing NHS Fife and Dr Upton, proposed the Isla Bryson comparison perpetuated the narrative that all trans women were predators, but Peggie clarified she was “describing how women must feel with a man in a female prison and how they might feel awkward having a man in the prison with them.”

The decision to suspend Peggie came from NHS Fife Clinical Nurse Manager, Esther Davidson, who said it was “the best decision at the time” to place the nurse on special leave.

Quizzed on the health board’s equality policy, she told the claimant’s barrister Naomi Cunningham: “Personally, for me you should treat people as individuals, regardless of their sex or sexual orientation - we should treat people as the sex they stipulate they are - that's what the policy states.”

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NHS Fife maintained throughout it had acted in line with the health board’s equality policy, and following the Christmas Eve altercation, Peggie had no means to object to Dr Upton using the female changing room.

As the second block of hearings loomed in July, a freedom of information request unveiled that NHS Fife had spent £220,000 defending itself and Dr Upton against Peggie’s case.

The unveiled cost to the taxpayer, together with the conclusion of the 18-month-long open investigation into Peggie’s conduct and the recent Supreme Court decision, immediately put NHS Fife on the back foot as hearings resumed.

The first witness called on July 16 was NHS Fife Equality and Human Rights Lead Officer Isla Bumba, who told the tribunal she wasn’t sure of her own sex in an extraordinary summer return to evidence sessions, but could “hazard a guess” that she was female.

She told barrister Naomi Cunningham: “I don't know what my own body is made of biologically” and “no one knows what their chromosomes are or the hormonal composition”.

After discussing the changing room, Judge Kemp asked Bumba whether she had seen the key location involved in the case.

When she replied “no”, he concluded, ”so you don't know what we are talking about”.

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In the final week, discussions revealed Peggie was not alone in objecting to Dr Upton using the women’s changing room and Judge Kemp agreed to permit the inclusion of evidence from two additional witnesses to support claims of a workplace culture using fear to prevent speaking out at Victoria Hospital.

Naomi Cunningham told Judge Kemp: “The truth is we have known about many other objectors in the beginning,” adding that while Peggie knows many stand silently behind her, “the difficulty is persuading anybody to come forward and tell the tribunal about it.

“That difficulty is caused by the price of speaking up about these issues inside NHS Fife.”

For Women Scotland co-director Susan Smith says: “The feeling that this was a toxic workplace was only intensified with the evidence of malicious gossiping, backstabbing, and a seeming determination to stitch up Sandie to protect Upton.”

She recalls the case taking a dark turn in July when the tribunal uncovered mismatched time stamps on Dr Upton’s screenshot notes recording interactions with Peggie, raising questions over their authenticity.

One note titled “Weird Incident” shows a creation date of October 2023 but lists an edit date of August 2023, which NHS Fife Information Security Advisor Peter Donaldson admitted “just isn’t possible”.

Susan says once Upton’s notes were discredited, the opposing counsel “went after [Sandie] personally,” accusing her of being a “racist homophobe” and forcing Sandie’s daughter and her girlfriend into defending the nurse after “using her relationship with her child”.

She says: “It was a new low”.

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Beth Upton’s changing room access was permitted by now-outdated EHRC guidelines, with public services - including the NHS - under increased scrutiny to update to new recommendations following the Supreme Court clarification of the Equality Act.

Sitting on the Scottish Parliament's Equalities, Human Rights and Civil Justice Committee, Conservative MSP Tess White says Peggie’s treatment was “completely unacceptable” and NHS Fife’s behaviour “resembled a witch hunt”.

She told GB News: “The hounding of a nurse simply for standing up for her right to single-sex changing facilities is completely unacceptable.

“This case exposes the urgent need for updated guidance from the SNP Government to public bodies on their need to comply with the law - but John Swinney shamefully drags his heels because he’s scared of upsetting the gender zealots in his own party.”

She said the First Minister “must stop dithering and ensure women’s rights are belatedly upheld,” warning the taxpayer risks footing the bill for future compensation.

Concluding 20 days in the Dundee Tribunal Hearing Centre, Peggie revealed she expects Dr Upton to pay her compensation if Judge Kemp finds in her favour, on top of a 25 per cent recompense from NHS Fife for “unreasonable delays” to the misconduct investigation that took 18 months to conclude no wrongdoing.

In addition to an apology from both Dr Upton and NHS Fife, Peggie says she will seek a protected disclosure detriment for unfair treatment after raising concerns over sharing the female locker room with Dr Upton.

As Peggie remains an employee of NHS Fife, any compensation will not include the loss of earnings.

Legal teams have until August 25 to submit supplementary statements and leading counsels will return to Endeavour House on September 1 to present oral summaries to Judge Kemp before he retires for an indeterminate length of time to make his final judgement.

To see such a high-profile employment tribunal playing out blow-for-blow in the public eye is extremely rare.

Judge Sandy Kemp’s conclusion is set to provide the first draft framework for addressing transgender workplace conflicts and will be referenced for years to come.