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Firth was appointed Member of the Order of the British Empire (MBE) in the 2017 New Year Honours for services to swimming.

On 26 April 2016, in the qualifiers for the 2016 Summer Paralympics in Rio, Firth set a new world record in the S14 200 metres freestyle. Competing at the British Para-International meet in Glasgow, she recorded a time of 2:03.70.

On 8 September 2016, Firth defended the title that she had won in 2012 in the S14 100m backstroke, for the 2016 Summer Paralympics at Rio de Janeiro. She did this, winning in a world record time of 1:04.05 whilst competing for Team GB.

In March 2015 Firth broke the world record for the S14 100m breaststroke in qualifying for that year's IPC World Championships. Firth failed to compete in the World Championships after suffering a fractured wrist in training just a few days before the competition.

Firth won three silver medals at the 2013 IPC Swimming World Championships.

Later in the same year she announced her intention to switch national team and swim for Team GB instead of Ireland after serving a period out of competition, as "Team GB has other S14 swimmers – who have learning disabilities – with whom she can relate." The following year she represented Northern Ireland in the 2014 Commonwealth Games, competing in seven events against able-bodied athletes.

On 31 August 2012 Firth, competing for Ireland in her first Paralympics, won a gold medal at the 2012 Paralympic games in London in the S14 100 metres backstroke final while representing Ireland. Firth, who has learning difficulties, had been swimming for only three years.

Bethany Charlotte Firth, MBE (born 14 February 1996) is a Northern Irish swimmer competing for Great Britain as of 2014; previously Firth had competed for Ireland. A four time Paralympic gold medalist, she has won gold in her specialist event, the 100 metres backstroke for both Ireland at the 2012 Summer Paralympics and Great Britain at the 2016 Summer Paralympics, in addition to the 200 metres medley and 200 metres freestyle for Great Britain at the 2016 Games, where she was the nations most successful Paralympian with three golds and a silver medal. She competes in the S14 classification for athletes with an intellectual impairment.

Bethany Charlotte Firth was born on 14 February 1996 in Seaforde, County Down, Northern Ireland. Her father Peter is a teacher and former church minister, and her mother Lindsey is a nurse practitioner. She is a Christian and is a member of Christian Fellowship Church. Firth was educated at Longstone School in Dundonald.