An employment tribunal in England stated Wednesday that a biblical view of sex and gender is “incompatible with human dignity” in a ruling against a doctor who was denied employment after refusing to use the preferred pronouns of transgender clients.

The tribunal’s ruling, conveyed Oct. 2, said: “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.”

Dr. David Mackereth, a Reformed Baptist who long worked at the National Health Service, was training to take a job as a disability assessor at the Department for Work and Pensions. At a June 2018 training session he said that he would not refer to a biological male as a woman. It is NHS policy to use the preferred pronouns of patients.

His instructor had said reports on those claiming disability must refer to the patient by their gender identity, in accord with the Equality Act 2010, an anti-discrimination law in England, Wales, and Scotland which includes sex, sexual orientation, and gender reassignment among its protected classes.

Mackereth said that he could not “use pronouns in that way in good conscience.” He also said that he thought it would be “irresponsible” for a doctor to “accommodate and/or encourage a patient’s impersonation of the opposite sex.”

His comments alarmed his supervisors, who asked him to confirm that he would not in fact be using preferred pronouns. He was fired shortly thereafter.

Mackereth protested the termination of his contract to the Employment Tribunal, saying that he had been discriminated against due to his Christian beliefs, and that his rights to freedom of thought, conscience, and religion had been breached.

He lost the case, and the ruling was made public earlier this week. The tribunal acknowledged that while Christianity is a protected class under the Equality Act 2010, the belief that people are born male or female, and that this could not be changed, is not.

The tribunal added that while they do not have any doubt that Mackereth is entitled to hold his beliefs, “what this case concerned is whether he was entitled to manifest those beliefs in the circumstances that applied here.”

Mackereth was critical of the decision, saying that his 30 years of medical experience “are now considered irrelevant compared to the risk that someone else might be offended.” He said that intellectual and moral integrity are key to medicine.

Andrea Williams, the chief executive of the Christian Legal Centre, which represents Mackereth, said the tribunal’s decision could have grave consequences for anyone who believes that people are born male or female and cannot change their gender. Williams is worried that this case will create a precedent for others.

“It is deeply disturbing that this is the first time in the history of English law that a judge has ruled that free citizens must engage in compelled speech,” she said.

After the ruling, a spokesperson for the Department for Work and Pensions defended Mackereth’s firing, saying that they were being proactive to safeguard transgender patients from his beliefs.

“We acted to protect claimants from behavior that would have failed to treat them with dignity, so we welcome this ruling. We expect all assessors to approach their work sensitively,” said the spokesperson.

Mackereth intends to appeal the decision.

“I believe that I have to appeal in order to fight for the freedom of Christians to speak the truth,” he said following the decision. “If they cannot, then freedom of speech has died in this country, with serious ramifications for the practice of medicine in the UK."