Dr David Mackereth reckons that he has treated more than 120,000 people during more than 20 years as an NHS A&E doctor.
As you might expect in a busy ‘Anything and Everything’ department, his patients have come in all shapes and sizes, and from every race and creed.
Young and old, he sees every gender and sexual orientation.
Dr David Mackereth reckons that he has treated more than 120,000 people during more than 20 years as an NHS A&E doctor
It makes no difference to him whom a broken arm belongs to, he says, and he has never refused to treat a patient.
As an evangelical Christian, he regards himself as a compassionate, caring and highly ethical doctor, but he always keeps his religious beliefs to himself.
‘If I were to impose my Christian views on patients, I would very quickly lose my job,’ he says.
‘My job is to treat their chest infection or sepsis, dress wounds and save lives. I cannot be prejudiced — nor would I want to be.’
So the quiet and unassuming married father-of-four never imagined he would find himself branded a ‘bigot’ by Piers Morgan on live breakfast TV, as he was last week, and fearing that he would never work as a doctor again.
Nor that he would be at the centre of a legal test case over one of society’s most divisive and incendiary issues — transgender rights.
Or, more specifically, the question over whether a doctor should be legally compelled to use the pronoun ‘she’ when addressing someone born a ‘he’ — and vice versa — on request, even if that conflicts with the medic’s religious beliefs.
Last week, Dr Mackereth, 56, told an employment tribunal that he lost his new job in a government department after he said he would refuse to refer to ‘a 6ft tall bearded man’ as ‘madam’.
He claimed he was sacked as a benefits assessor by the Department for Work and Pensions (DWP) over his religious beliefs and that he is the victim of discrimination.
The doctor alleged that during his two-week training he was asked this hypothetical question in June last year, just four days into the job: ‘If you have a man, 6ft tall with a beard, who says he wants to be addressed as “she” and “Mrs”, would you do that?’
When Dr Mackereth, from Dudley in the West Midlands, said his religious conscience would not let him do so, he claims he was dismissed.
He further alleged that no effort was made to accommodate his beliefs, such as referring transgender clients at Birmingham’s Five Ways Assessment Centre to another doctor.
But centre manager James Owen denied this — telling the tribunal there had been no such ‘bearded man’ discussion, nor had Dr Mackereth been suspended or sacked.
Describing the meeting, Mr Owen said: ‘I asked the claimant if he would respect the customer’s wish to be referred to by their chosen sexuality and name and would he convey that in his written report.
‘The claimant categorically stated that he would not do that due to his beliefs and he could not put that in a report as his conscience would not allow that. The claimant also stated that he understood that his behaviour could be offensive.’
Mr Owen told the tribunal, which ended on Friday, that ‘at no point was the claimant asked not to come back into work’, and added that he ‘respected his wishes not to work’.
Dr Mackereth found his vocation in A&E, working mostly as a night doctor in various hospital departments around the UK. Above: The Princess Royal Hospital in Telford, Shropshire, where Dr Mackereth worked for seven years before his new job at the DWP
The tribunal heard that Dr Mackereth did not attend work following the meeting, claiming he was waiting for a decision from the DWP which argued his religious objections were in breach of the 2010 Equality Act.
The DWP asserted that the doctor chose to leave his job.
APM, the recruitment company which hired the medic, is also being sued for religious discrimination.
The company claims the doctor’s beliefs ‘are not compatible with human dignity’.
The reserved judgment is expected in September.
So what does Dr Mackereth say to those who might agree with Piers Morgan’s accusation of ‘bigotry’?
‘I was quite literally gobsmacked when he called me a bigot and when I asked him what he meant by that, he didn’t even reply,’ says Dr Mackereth.
‘But, historically, the word “bigot” was applied to people like myself who refuse to compromise their consciences.
That is actually a badge of honour, no matter how the word is used today. So although it is meant as an insult, for me as a Christian, it’s actually a compliment.’
But why shouldn’t we all have the legal right to be referred to by whatever name or pronoun we choose? In this gender-fluid age — when social media sites offer us at least 58 gender options — why does it even matter?
And what about those vulnerable people being assessed for disability benefits, who may suffer from severe physical or mental health problems, and whose wellbeing may depend on every word written about them by their medical assessor?
Dr Mackereth says he fully accepts that some people — Christians among them — sincerely believe they were born trapped in the wrong body and that they are happier self-identifying as a different gender.
That is their right, he says, just as it is his to hold a different view and freely express it.
‘If a person has a genuine dysphoria and they believe they are trapped in the wrong body with considerable conviction, I can’t answer the question as to whether that is true or not,’ he says.
‘All I can say is that I don’t believe you can change sex and I don’t believe you can be trapped in the wrong body, but I accept that they believe both and there should be no hesitation on my part in treating such people.
‘I am not looking for trouble, nor do I want to upset people or cause them distress. I’m not going round prodding people saying: “Come on, you’re not really a woman.” I have great compassion for every patient I see.
‘But I cannot change the fact that, as a Bible-believing Christian, I hold that God made people male and female and that this cannot change.
The quiet and unassuming married father-of-four never imagined he would find himself branded a ‘bigot’ by Piers Morgan on live breakfast TV, as he was last week, and fearing that he would never work as a doctor again
‘I therefore consider it sinful and undermining to Christian theology to change the way that we use pronouns.
‘I’m not trying to offend anybody, although I accept some people may find such beliefs offensive.
‘We haven’t set out to attack transgender people — we want to stress that as Christians we love transgender people, although we do not agree with the transgender movement.
‘The point is that, if we are saying that God made us male or female, then we are talking about something that cannot change, theologically or scientifically, so by using pronouns in a different way we would be lying. We would be dishonest.’
Whether his case is successful or not, Dr Mackereth believes the outcome could have significant legal implications for everyone — but especially the medical profession.
Today, Dr Mackereth is back working for the NHS part-time, as an A&E doctor in Shropshire — but after his DWP job came to an abrupt end, he says he was terrified he’d never work again
‘Someone who presents quite obviously as male is entitled to say “Call me Mrs” or “Call me she”, but the question is, am I legally obliged to do that?’ he asks.
‘And if you are legally obliged to refer to patients in a way your conscience does not allow, does that mean you are no longer fit to be a doctor?
‘This case is all about whether I am legally clear to say — on the grounds of my religious conscience — “No, I can’t call you ‘she’ or ‘he’, not because I want to hurt you or don’t accept you, but because my Christian convictions simply won’t allow me to do that”.
‘The pronouns “he” and “she”, in particular, are like the glue that holds our language together.
‘Words can be more powerful than atomic bombs if used in a new way.
‘If they become fluid in their meaning, and are used in an arbitrary way, they then simply become meaningless.
‘Add to that the legal sanctions if you misgender someone, and I believe we have a very complicated and troubling problem on our hands.
‘We could be on the verge of committing a hate crime for simply using the wrong pronoun.’
Born in Surrey, Dr Mackereth says he was an atheist before he discovered Christianity at the age of 18 through his religious friends at St Andrews University in Scotland, where he started his medical degree.
He graduated as a doctor from Manchester University in 1988 and took four years out from 1990 to 1994 to study theology and work in evangelical ministry.
Returning to medicine, he found his vocation in A&E, working mostly as a night doctor in various hospital departments around the UK.
‘I love A&E. I like contact with people, I like the sense that I have no idea what kind of condition I am going to see next.
‘I like complicated challenges, conundrums, and the tremendous camaraderie,’ he says.
‘During that time there were three transgender patients I can recall, but there may have been a hundred more for all I know and I just didn’t realise.
‘I may even have used the wrong pronoun, but that is not a sin if you don’t know. I treat everyone who walks through our doors without judgment or prejudice.’
He got around the issue of how to address the transgender patients he did know about by simply referring to them by their name, and calling them ‘the patient’ in notes. An easy solution which, he says, was never complained about.
‘In the NHS and A&E the issue over gender isn’t quite as tense. I may have felt a bit awkward putting a female name for someone who was born biologically male, but even as a Christian it would have been very hard for me to come up with an argument not to use their chosen name.’
It wasn’t so easy after he applied for the new job with the DWP, however.
He’d gone for the post following surgery for heart disease, hoping to find a less stressful nine-to-five job which would also give him time to develop medical technological advances.
‘A DWP report is written in very exact legal language, and the very precise, rigid format is that you begin with the client’s name and the rest of the report uses the pronoun “he’ or “she”,’ he says.
‘During the DWP training in London, the question was raised not by myself, on account of the fact that — for most of us doctors — this is a new situation, where we are being required to use pronouns in a different manner to what we are familiar with.
‘I was able to say that, as a Christian, I had a problem with my conscience in using those pronouns in what I alleged was an arbitrary manner — as in anyone could come along and say they wanted to be called “he”, “she”, “Mr” or “Mrs” when that could not be proven medically or scientifically.
‘There is an awful lot of confusion among the people I work with about what we can and cannot say, and what we are allowed to do and are not allowed to do.
‘The implication of forcing us to use this language is very important for society, as if we are not allowed to follow our convictions, that is the day we lose our freedom.
‘A transgender person is perfectly entitled to say “I want to be called by such and such a pronoun”, but to compel me to use that pronoun is a really important step.
‘I would even argue that if you were to take every doctor and nurse with a conscience off the NHS because of this matter, there wouldn’t be much of an NHS left.’
Today, Dr Mackereth is back working for the NHS part-time, as an A&E doctor in Shropshire — but after his DWP job came to an abrupt end, he says he was terrified he’d never work again.
‘So many doctors and nurses have secretly said to me “We agree with you David, we’re very concerned about what is going on,” says Dr Mackereth, who believes many like himself fear being branded transphobic.
‘There is a massive groundswell of support, but there is a climate of fear,’ he adds. ‘It seems to be all right for one side to talk about transgender issues, but not the other.
‘There are multitudes of doctors and nurses who are very concerned because when we are compelled to do something we disagree with — contrary to our beliefs — we lose our integrity.’
‘The transgender movement, which has now been accepted by the mainstream, has for many of us suddenly come out of nowhere and we are expected to believe and accept it,’ he adds.
‘But it’s not being accepted by everybody. Far from it. It’s being pushed on society with great rapidity without taking the time to listen to what people have to say. It’s almost like a form of moral coercion.’
Dr Mackereth is being backed by the Christian Legal Centre, whose director Andrea Williams said: ‘This case has huge ramifications for who and what we are as a society and the language we can use.
‘If we sacrifice freedom of thought, conscience and religion, no other freedom is safe.’
The DWP told the Mail it could not comment on the case before the judgment.
Should he lose, Dr Mackereth’s fear is that future doctors could be barred from working — or not employed in the first place — if they refuse to compromise their religious beliefs.
‘I work in a situation where we save lives every day,’ he says. ‘If you take me out of the equation, for the sake of a pronoun, who is going to save the lives I am saving?
‘And if you only employ doctors who agree with you, then you no longer have a service with a conscience.’