A transgender doctor at the centre of a changing room dispute that sparked a costly legal battle in the UK is now working in the NSW health system.
Dr Elisabeth Upton, 30, relocated to Australia after leaving the UK’s National Health Service (NHS) at the end of last year, following a high-profile case in a Scottish employment tribunal.
Australian Health Practitioner Regulation Agency (AHPRA) records show Dr Elisabeth Ruth Annikki Upton is now registered as an unaccredited trainee in emergency medicine as of April 9.
Dr Upton has not been accused of any wrongdoing in Australia or the UK.
“We can confirm that Dr Elisabeth Ruth Annikki Upton holds provisional registration as a medical practitioner in Australia, as shown on the public register of practitioners,” an AHPRA spokesman said.
Dr Upton, whose sex is listed as “female”, is approved to work under supervision at Port Macquarie Base Hospital and Kempsey District Hospital.
When applying for registration, practitioners may indicate that their sex is male, female or intersex, and this information is recorded and confirmed against legal identity documentation.
The national law does not define the term “sex”, and there is no separate requirement to record “gender” on the register.
Nurse Sandie Peggie took Dr Upton and NHS Fife to the tribunal after she was suspended following her complaints about the junior doctor’s use of the female changing room in Victoria Hospital, Kirkcaldy, alleging her experiences amounted to harassment, discrimination and victimisation under the UK’s Equality Act 2010.
Ms Peggie claimed that in 2023, Dr Upton had undressed in front of her, and on another occasion walked in while she was dressed in her bra and trousers, causing her to put her top back on and wait outside until Dr Upton left.
She was suspended after a doctor made a complaint at the beginning of 2024.
The nurse, who had worked at the NHS for 30 years, faced allegations of misconduct, failures of patient care and misgendering Dr Upton, but was cleared of gross misconduct last July in disciplinary proceedings by NHS Fife.
In December, the Employment Tribunal Scotland dismissed Ms Peggie’s claim against Dr Upton but ruled NHS Fife had harassed her on four occasions.
Her claims of victimisation and discrimination based on her “gender critical” beliefs were dismissed.
The health board has since confirmed its legal bill in the long-running case has exceeded £400,000 ($754,000).
The Employment Tribunal heard that Dr Upton, who is “about six feet tall”, had begun transitioning around January 2022, using the name Elisabeth or Beth and female pronouns, and “presents in what is generally regarded as a feminine manner”.
It was agreed with a supervisor that Dr Upton would be allowed to use the female changing rooms after starting work at the hospital as a junior clinical fellow in August 2023.
The tribunal’s decision noted that Ms Peggie “believes that biological sex is real, important, and immutable, and is not to be conflated with gender identity”.
“She holds a belief both referred to as ‘sex realist’ and also as ‘gender-critical’,” the tribunal said.
“That includes a belief that those who are biologically male, including trans women, are not entitled to use female only spaces such as the changing room.”
Isla Bumba, the equality and human rights officer at NHS Fife, told the tribunal that at the time Dr Upton was hired, the health board did not have any policies in place for the facilities transgender staff should use.
She advised colleagues that, based on the “general consensus” of other health boards in Scotland and England, it would be discriminatory to “not allow a trans person access to facilities that aligned with their gender”.
Ms Peggie told the tribunal the issue came to a head on Christmas Eve 2023 when Dr Upton started to undress in front of her. She alleged that she felt “embarrassed and intimidated” by Dr Upton’s presence in the female changing room, and the pair exchanged words.
During the argument, Ms Peggie is alleged to have asked Dr Upton, “What are your chromosomes?”
The tribunal ruled that NHS Fife should have revoked Dr Upton’s permission to use the female changing room on an “interim” basis after Ms Peggie’s initial complaint.
However the tribunal found Ms Peggie’s comments to Dr Upton “amounted to harassment” in breach of NHS Fife’s bullying and harassment policy, contrary to the findings of the health board’s internal disciplinary proceedings.
“Unlike [NHS Fife] in its process with [Ms Peggie] we had the benefit of evidence from both [Ms Peggie] and [Dr Upton], given on oath, with representation and documentation that we have assessed in light of all the evidence,” the tribunal said.
Ms Peggie is now appealing against several of the tribunal’s rulings.
“Whilst I am delighted that the tribunal was critical of Fife Health Board and found they harassed me, their judgement I believe falls short in many respects and that is why I certainly won’t be giving up this legal fight any time soon,” she told a press conference in December.
