There is no excuse for a male doctor to present themselves to a female patient who has requested a female doctor. From the report, this is what this male doctor has done. He also has declared to the many people watching the employment tribunal where he gave evidence that he could see no issue in doing so. He expects that female patient to have to reject him or to accept him with him knowing that he was male.
Meaning he was demanding a female patient, who has a quite high chance of being a vulnerable female patient, decide whether or not he was 'female' and whether she would risk being negatively treated for rejecting him.
There is a valid discussion around consent to be had about that behaviour.
It is not that the man is 'trans'. It is that he is a male doctor who has publicly declared that he would not respect female patients wishes immediately before putting the patient in the situation where they had to reject him based on observation if they had that capacity, because he would ignore their request and present himself as if he was a female doctor that they requested.
This should not be acceptable in any way.