Sandie Peggie, a senior NHS nurse at Forth Valley Royal Hospital in Scotland, has been cleared of gross misconduct charges following an 18-month tribunal that examined her alleged mistreatment of Dr. Beth Upton, a transgender physician. While Peggie’s supporters have framed the verdict as a win for “biological reality,” the case has raised significant concerns over the treatment of trans professionals in the UK’s healthcare system and over how personal beliefs can affect clinical environments.
The tribunal, overseen by the Nursing and Midwifery Council (NMC), concluded on July 16 that Peggie’s actions did not amount to professional misconduct. The charges stemmed from an incident in 2022 when Dr. Upton, who is transgender, was reassigned to a new changing room. That action was allegedly influenced by Peggie’s disapproval of her presence in the women’s staff area.
The case first drew national attention when excerpts from Peggie’s personal diary were submitted to the tribunal, revealing strong language regarding Dr. Upton’s gender identity. In one entry, Peggie reportedly referred to Upton as a “man masquerading as a woman” and expressed deep discomfort at sharing workplace spaces with her. These entries, which surfaced only after Peggie’s suspension, became a focal point in the case, as did allegations that hospital leadership had acted on Peggie’s biases.
Throughout the proceedings, Dr. Upton’s name was widely publicized in the media, despite her not being the one on trial. Speaking through representatives, she described the experience as humiliating and dehumanizing, citing the breach of her confidentiality and the public scrutiny of her identity. While Peggie was ultimately cleared, the tribunal acknowledged that her comments lacked empathy and demonstrated poor judgment, even if they did not violate professional conduct standards.
Dr. Upton, a respected trauma physician who transitioned in 2020, has continued working throughout the ordeal. However, sources close to her say the stress has taken a toll. She has not spoken publicly since the verdict, but her allies, including LGBTQ+ advocacy groups and NHS colleagues, have expressed frustration with how the situation was handled.
“This case isn’t just about one nurse and one doctor,” said an NHS Equality Network member who asked to remain anonymous. “It’s about whether trans professionals can feel safe and respected in their own workplace.”
Meanwhile, Peggie has announced she is pursuing legal action against NHS Forth Valley for what she claims was an unjust suspension and breach of her rights. Her legal team alleges she was punished for expressing “gender-critical beliefs,” framing the dispute as part of a broader free speech issue. That narrative is now being amplified by right-wing media and politicians in the UK.
The case continues to spark debate across the UK about how healthcare systems manage internal conflict involving gender identity, especially as trans rights remain under attack in both political and media spheres.
For Dr. Upton and many others, the outcome may be less about the verdict and more about the message it sends.
“It’s exhausting,” said one trans NHS clinician who requested anonymity. “We do our jobs, we care for patients, and yet we’re made into the controversy.”
