He also believed that “it would be irresponsible and dishonest for e.g. a health professional to accommodate and/or encourage a patient’s impersonation of the opposite sex,” he told the tribunal.

Dr. Ahmed expressed concerns about Mr. Mackereth’s comments during a weekly staff meeting, and it was later decided that James Owen, a contract manager for APM, should talk to Dr. Mackereth about the matter , the tribunal heard.

In that conversation, Mr. Owen told Dr. Mackereth that he was at risk of losing his job, and Mr. Mackereth said in his witness statement that he felt pressured to renounce his beliefs in order to keep it.

In an email exchange a few days later, Mr. Owen asked Dr. Mackereth whether he agreed to “refer to the customer by their chosen sexuality and name.” If he did not wish to do so, Mr. Owen told him, the Department for Work and Pensions would respect his decision and his right to end the employment contract.

“I am a Christian, and in good conscience I cannot do what the D.W.P. are requiring of me,” Dr. Mackereth replied, according to the tribunal report.

Mr. Owen then accepted his resignation, but Dr. Mackereth replied in an email that he had been fired .

In its ruling, the tribunal panel found that Dr. Mackereth had not been discriminated against or harassed under the Equality Act. Christianity is protected under the act, but the panel found that Dr. Mackereth’s specific beliefs were not.

It ruled that “belief in Genesis 1:27, lack of belief in transgenderism and conscientious objection to transgenderism in our judgment are incompatible with human dignity and conflict with the fundamental rights of others, specifically here, transgender individuals.”