I've not read the decision yet - but this seems promising!
I actually think that the Dr Upton's request to be called "Dr Upton" if pronouns can't be agreed on is reasonable, although if the judge had simply decided that titles should be used it would have been a bit ambiguous as "Dr" is both sex and gender neutral. For example, if it had been another nurse asking to be called "Miss Upton" it would not be as straightforward - so it is useful that the claimant can say "he" if necessary.
(Use of "Dr Upton" also emphasises the hierarchal element of the relationship between the parties, which may well be relevant in the case.)
I also think it is no bad thing to specify that the tribunal will intervene if male pronouns are “used gratuitously and offensively on a repeated basis with no good reason to do so” - I can't imagine that this would be done deliberately, but it will be interesting to see what, if any, use will be considered "offensive" by the tribunal as this is something that is often discussed.
Link: https://www.thecourier.co.uk/fp/politics/scottish-politics/5169032/nurse-nhs-fife-trans-doctor-tribunal/