Dr David Mackereth claims he was sacked after saying he would not "call any 6ft tall bearded man madam" during an "abstract discussion" with his manager.
The 56-year-old, from Dudley, West Midlands, alleges the Department for Work and Pensions (DWP) discriminated against his religious beliefs, costing him his job as a disability claim assessor.
As well as claiming religious discrimination, Dr Mackereth maintains that no effort was made to accommodate his beliefs, such as referring transgender clients at Birmingham's Five Ways assessment centre to another doctor.
On the third day of the Birmingham tribunal, centre manager James Owen said he had a meeting with Dr Mackereth on June 13 last year and then "respected his wishes not to work".
In a written statement describing the meeting, Mr Owen said: "I then 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 added: "I read the answers back to the claimant and asked him to confirm if I had captured the information correctly. The claimant agreed.
"The claimant clearly stated that he would not address the transgender customers according to their preferred pronouns due to his Christian beliefs and that God would not allow him to do that."
During the meeting, Mr Owen said, Dr Mackereth was upset by the whole situation, saying "the government, the law and the GMC (General Medical Council) were all against people like him and he knew how this would end and that it would not be in his favour".
Mr Owen told the tribunal: "I reiterated to the claimant that I did not know what the outcome would be and that it would not be my decision."
Mr Owen added: "We shook hands and I said to the claimant that I would be in touch. At no point was the claimant asked not to come back to work."
The contract manager, who worked for an employment service provider to the DWP, said another staff member informed him the following day that Dr Mackereth had told her he "felt he could not work" and had asked whether he could go home and not return until a decision had been made.
Mr Owen said: "I called David that afternoon to check he had arrived home OK and to confirm (the other manager) and I understood his request not to continue working.
"At no point was David suspended from work."
After receiving an email on June 15 in which Dr Mackereth asked for written reasons from the DWP for his suspension, Mr Owen replied to say he understood the doctor had "left work because he chose to do so" and had stated that he did not feel he could return until the situation was resolved.
Asked if he had mentioned a hypothetical "6ft tall bearded man" during the discussion with Dr Mackereth, Mr Owen said: "No I did not, it didn't happen. I never asked that question."
The hearing continues today.
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