How Sandie Peggie-Dr Beth Upton tribunal has revealed class divide at heart of gender debate

Gender identity theory is largely a middle-class pursuit, says Susan Dalgety

When giving evidence at the employment tribunal brought by nurse Sandie Peggie earlier this week, respondent Dr Beth Upton got to the heart of the matter early on. “I’ve never been spoken to like that in my life,” said the medic, describing the nurse’s reaction when she discovered the doctor – born male – stripping off in the female changing rooms at Victoria Hospital in Kirkcaldy.

Picture the scene. It was near midnight, Christmas Eve 2023. Sandie Peggie was in the middle of a night shift in the Accident and Emergency department. She was also in the throes of a heavy period.

It’s a little known fact, at least among men, but as women approach the menopause, our periods can often become very heavy. Blood can flood out of your body at the most inconvenient time, seeping through your clothes. The female reproductive system is a miraculous thing. It can also be inconvenient, as Sandie Peggie found that night.

She explained to the tribunal that she was experiencing heavy menstruation and felt "embarrassed" and "intimidated" when Dr Upton entered the changing room and began undressing.

Sandie Peggie, centre, a nurse at Queen Margaret Hospital in Dunfermline, arrives at an employment tribunal in Dundee (Picture: Andrew Milligan) | PA

The temerity to challenge a doctor

Dr Upton, for those who have not been following the case, was born male and is at least 6ft tall. Make-up and discreet silver jewellery cannot mask the good doctor’s male physiology. As Sandie Peggie told the tribunal, she was not discomfited by Dr Upton being transgender, but by having to share female changing facilities with a male-bodied person, as indeed most women would be, especially when bleeding heavily.

She made her feelings clear, much to Upton’s distaste. As the solidly middle class doctor, still in his 20s, told the tribunal, “I’ve never been spoken to like that in my life.”

Shortly after the encounter, Sandie Peggie – a respected nurse with 30 years’ experience – was marched out of Victoria Hospital, suspended for having the temerity to challenge a doctor, despite a 1992 workplace regulation which states that changing facilities are not suitable “unless they include separate facilities for, or separate use of facilities by, men and women where necessary for reasons of propriety”.

The employment tribunal, which will continue into the summer because of NHS Fife’s inability to produce essential documents in time, has not only exposed the nebulous nature of gender identity theory – that a human being can change their sex through sheer will – but the ingrained class divide at the heart of the NHS that also characterises the debate around gender.

Gender identity theory is largely a middle-class pursuit, a fake radicalism which doesn't bother its pretty little head with tackling the material causes of poverty and inequality. Instead, as feminist writer Sheila Jeffries argued in 2014, it is a social construct designed to maintain male dominance. And since its inception, the National Health Service has put the demands of the doctor class first before the needs of the largely working-class nursing and support staff.

Middle-class arrogance

Former Labour MSP Jenny Marra, who attended the tribunal over several days, said the evidence reeked of class and entitlement. She observed: "Middle-class arrogant male doctor breaches nurse's boundaries is not a new story. But this time the doctor is facing down the nurse with the backing of politicians and illegal guidelines drawn up by public sector officials who have been hoodwinked into betraying reality and the many working-class women at the frontline of our public services.”

So where will the working-class women who provide so much of our health and social care find support and help in their fight for their basic rights – such as single-sex changing rooms? Why, the trade union movement of course. Or will they?

In an ironic twist of fate, the UK’s largest union Unison held its national women’s conference in Edinburgh this week, and the first motion to be debated called for the Labour government to introduce self-ID, the process where someone can change their legal sex by filling in a form. “Trans women are women,” read the motion which also criticised women who campaign for female-only spaces as “reactionary”.

Frightened by consequences of dissent

Unison’s robustly male president Steve North (pronouns he/him) crowed on social media that not one delegate had spoken against the motion but, as is often the case with carefully stage-managed political conferences, the reality was rather different to that described by President North. Women who were prepared to debate the issue were so intimidated by the hostile atmosphere that they left the meeting, unable to face being called bigots by the very noisy supporters of the motion.

As one delegate said: “The atmosphere was so toxic that even abstaining would have been noticed. Many of the delegates are working-class women in frontline public service jobs. Their fear of dissension reveals their very real fear of losing the protection of their union.

“When Steve North brags about the lack of dissent, does he not realise how important our union is to us and why seeing what has happened to Sandie Peggie makes women frightened to risk the real-life consequences of dissent.”

It is not surprising that middle-class professionals, whether doctors, HR managers or even politicians, have found comfort in the simplistic politics of identity. How much easier it is to pin a trans ally badge on a set of scrubs or business suit than begin to tackle the centuries’ old structural issues that trap millions of women in low-paid jobs, poor housing and ill-health, often at risk of sexual violence and abuse.

There is much about the gender debate that has left women aghast in recent years, from placing male rapists in female prisons to the scandal of the NHS mutilating young women’s bodies in the name of progress.

But surely one of the greatest betrayals is a trade union whose membership is three-quarters female, ignoring the material reality of women’s lives in favour of a fanciful theory that sex can be cast off as easily as last season’s fashions.