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A nurse who confronted a transgender doctor in a changing room behaved in an "unacceptable" way, an employment tribunal has heard.
Gillian Malone - who is head of nursing at NHS Fife - said nurse Sandie Peggie should have raised concerns about sharing facilities with Dr Beth Upton - a trans woman - in a different way.
Ms Peggie and Dr Upton exchanged words on Christmas Eve 2023 after the nurse told the doctor they should not be in the same changing room at the Victoria Hospital in Kirkcaldy.
Ms Malone said Ms Peggie's comments that Dr Upton was a man constituted unacceptable conduct.
After the exchange, Dr Upton complained to NHS Fife about Ms Peggie's behaviour and the nurse was suspended on 3 January 2024.
Ms Peggie claims her treatment was unlawful under the 2010 Equality Act and brought a case against NHS Fife, which resumed on Wednesday after a five month break in proceedings.
Ms Malone told Ms Peggie's lawyer Naomi Cunningham that it was "unacceptable for any colleague to confront another in that manner", referring to the Christmas Eve incident.
Ms Malone added that the nurse "could have raised the matter but not as a confrontation".
She suggested Ms Peggie should have returned to her line manager and then escalated her concerns from there.
Ms Malone said she understood the incident in the changing room had involved Ms Peggie questioning Dr Upton about her chromosomes and referencing Isla Bryson, a rapist who is also transgender.
Ms Cunningham questioned whether there was any way Ms Peggie could have raised concerns to Dr Upton's face without being at risk of suspension.
Ms Malone said there was no way the matter could have been resolved in that conversation.
The lawyer added that the "essence" of the matter was Ms Peggie feeling intimidated by the presence of Dr Upton in the changing room.
Ms Malone earlier said she found out about the "concerning allegations" on 2 January, after she returned to work following the Christmas break.
She added the allegations around Ms Peggie's behaviour on Christmas Eve involved offensive and inappropriate questions and use of derogatory terms to Dr Upton.
She told the tribunal the decision to suspend Ms Peggie was made following a risk assessment carried out by Esther Davidson, the nurse's line manager.
However, Ms Malone said she could not recall seeing the risk assessment herself.
Ms Malone also said she disagreed with the decision by Dr Kate Searle to send out an email about the confrontation to more than 20 other consultants on 29 December.
Ms Cunningham said this meant "confidentiality was lost" in the case, given that some of those involved were potential witnesses. Ms Malone agreed it should not have been handled in that way.
On Wednesday, Ms Peggie was cleared of gross misconduct following disciplinary proceedings by the health board.
She was accused of misconduct, failures of patient care and misgendering Dr Upton.
NHS Fife said an internal hearing found there was "insufficient evidence to support a finding of misconduct".
