NHS Fife is “in the grip of delusion” over gender self-identification, an employment tribunal has heard.

A lawyer for Sandie Peggie claimed this had led to “weird behaviour” in the health board’s case for suspending the nurse.

Ms Peggie objected to the presence of Dr Beth Upton, a transgender woman, in a female changing room at the Victoria Hospital in Kirkcaldy.

This led to an encounter between the pair on Christmas Eve 2023 and afterwards Dr Upton complained about the nurse. Ms Peggie was suspended and took the health board and the doctor to a tribunal.

However, the health board’s lawyer said Ms Peggie had made her discrimination claim because she realised she had “not got away with bullying and harassment” of the medic.

Naomi Cunningham KC, representing Ms Peggie, was speaking on the first of two days of closing submissions at the tribunal, which began in February.

The lawyer claimed NHS Fife’s behaviour following the suspension of Ms Peggie had been “morally repugnant” and that the health board’s case was filled with examples of “weird behaviour”.

She added: “There is one cause for all the bizarre behaviour – an organisation in the grip of delusion.”

The KC added that there was “a delusion deliberately fostered, and successfully propagated” regarding gender self-identification by a number of health boards.

Those comments were in reference to evidence earlier in the tribunal from NHS Fife’s equality and human rights officer Isla Bumba.

Ms Bumba previously said there was a general consensus among health boards in Scotland and England about letting trans staff use facilities that aligned with their gender.

The lawyer added that the health board subjected Ms Peggie to a “full blown witch-hunt” and “shockingly spiteful character assassination” during the tribunal, which saw racist jokes from old text messages read out.

Ms Cunningham said this was taking an isolated example from several years worth of messages sent by the nurse.

She also said trans women should be excluded from women-only spaces as they were “still men” both “legally and factually”.

She cited this year’s Supreme Court judgement regarding the definition of a woman on multiple occasions during her argument and claimed that, prior to the ruling, it had “been made taboo to say that trans women are men”.

Jane Russell KC, representing the health board, later responded that the Supreme Court ruling also stated it was not disadvantaging or removing protections for trans people.

She also said that NHS Fife believed there was no coherent reason to exclude Dr Upton from the changing facilities.

Ms Peggie claimed being made to share a changing room with Dr Upton amounted to unlawful harassment under the Equality Act and took the health board to an employment tribunal.

The nurse had been suspended by NHS Fife in the aftermath of the Christmas Eve incident.

The health board previously called the case unnecessary and vexatious, while Ms Peggie was accused of waging a “vindictive campaign” against Dr Upton.

Ms Russell said Ms Peggie and her legal team were “trying to fit a square peg into a round hole” by applying gender critical arguments to the case.

The lawyer said NHS Fife had still not received any further complaints regarding Dr Upton’s presence in the female changing rooms.

She also dismissed Ms Cunningham’s earlier claim that a “climate of fear” at the hospital stopped people from coming forward to raise concerns.

She said there was no evidence of this beyond Ms Peggie’s own claims and that Dr Upton’s life was being affected “by the prejudices of somebody else”.

Ms Russell added that Ms Peggie had “crossed a line” by deciding to “confront” the doctor on Christmas Eve.

Ms Peggie’s legal team also raised what it called “remaining mysteries” surrounding the health board’s decision to suspend the nurse, and the investigation that followed.

These centred around whether allegations of prior encounters between Dr Upton and Ms Peggie had placed patients at risk.

As the claims “swung in and out of view” throughout the process, Ms Cunningham described them as puzzling and bizarre in how they were handled by NHS Fife.

Ms Russell focused on the “gratuitous harm” she said Ms Peggie’s comments on Christmas Eve 2023 had caused Dr Upton, including misgendering the medic and a disputed comparison to the rapist Isla Bryson – which the lawyer called “a slur”.

The final day of closing submissions takes place on Tuesday, and Judge Sandy Kemp said deliberations on the case will take place on 14 October for four days.