A U.K. employment tribunal has upheld the termination of a Christian doctor who refused to refer to trans women by the correct pronouns.

Dr. David Mackereth worked as a disability claim assessor in the Department of Work and Pensions (DWP) with the National Health Service (NHS) until June 2018 when he informed his former supervisor, James Owen, that he would not “call any six-foot-tall bearded man ‘madam’ on his whim.”

Owen instructed Mackereth that he was required to adhere to the “process as discussed in [his] training,” which includes referring to trans people by their name and proper pronoun, according to The Telegraph. Were he to not follow these requirements, his supervisor informed Mackereth that he was “overwhelmingly likely” to be dismissed from the position.

“If… you do not want to do this,” Owen said, “we will respect your decision and your right to leave your contract.”

Citing his religious faith, Mackereth said he could not comply with the order. “I am a Christian and in good conscience cannot do what the DWP is requiring of me,” the 56-year-old employee responded.

Mackereth claimed he was subsequently fired from the position and filed a lawsuit against DWP, claiming he had experienced discrimination due to his faith beliefs. He has further called “transgenderism” a “delusional belief,” claiming it suggests that “gender is no more than one’s own fantasy about oneself.”

In a unanimous ruling, an employment tribunal dismissed Mackereth’s claim that he had been unfairly targeted because of his religion. The panel found his anti-trans comments “incompatible… with the fundamental rights of others” and said they were likely to result in “violating a transgender person’s dignity… or subjecting a transgender person to less favorable treatment.”

Mackereth plans to challenge the ruling, according to The Independent. During the tribunal hearing, he reportedly told panelists that “the very fact [that] a doctor can be pulled of the shop floor for an urgent interrogation about his beliefs on gender fluidity is both absurd and very sinister, even more so if it results in a dismissal.”

“If something like that happened in a church setting — people being pulled out of a pew, questioned, and then excommunicated — that would be seen as an outrageous example of religious intolerance and bigotry,” he said.

However, his former employer has insisted that Mackereth was not dismissed from the position and chose to leave the NHS of his own volition. In an interview earlier this year, Owen told the BBC that Mackereth “felt he could not work” under the conditions prescribed by his superiors but said the department ultimately left the decision whether to continue Mackereth’s employment up to him.

“I understood his request not to continue working,” Owen said, adding: “At no point was David suspended from work.”

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