On August 16th, 2022, the U.S. Court of Appeals for the Fourth Circuit (the Fourth Circuit) ruled that gender dysphoria is a disability under the Americans with Disabilities Act (ADA). The Fourth Circuit hears appeals in the states of Maryland, North Carolina, South Carolina, Virginia, and West Virginia. The ruling reversed an earlier Virginia trial court’s decision to dismiss a lawsuit brought against the Fairfax County Adult Detention Center by a transgender female with gender dysphoria. Additionally, the Fourth Circuit’s ruling applies equally to the Rehabilitation Act of 1973, which prohibits employment discrimination against individuals with disabilities in the federal sector. This isn’t the first time an appellate court further interpreted the ADA this year. Earlier, the Court of Appeals for the Ninth Circuit ruled that temporary conditions can be disabilities under the ADA.

Background of the Gender Dysphoria Case

Kesha T. Williams, a transgender female with gender dysphoria, alleged that the treatment she received while detained at the Fairfax County Adult Detention Center violated her rights under the ADA. According to Williams’ lawsuit, she was wrongfully detained among the prison’s male population. In addition, she was denied requests for reasonable accommodations and medical treatment for her gender dysphoria. Specifically, the necessary treatments included hormone therapy she had been receiving for 15 years. Finally, Williams also alleged she was searched by male officers, harassed by prison staff and other inmates, and purposely misgendered.

Qualifying Disabilities Under the ADA

Signed into law in 1990, the ADA is a federal law that protects the civil rights of individuals with disabilities. The ADA forbids discrimination in the workplace and other sectors of society against people living with disabilities. Covered individuals may show they have a disability in one of three ways:

  • they have a physical or mental condition that substantially limits a major life activity (walking, talking, seeing, learning, etc.)
  • a person has a history of disability (for example, a cancer that is in remission)
  • this person is subject to an adverse employment action, and their impairment is not transitory or minor

The Fourth Circuit Holds that Gender Dysphoria is a Disability

Fairfax County Adult Detention Center Sheriff Stacey A. Kincaid sought dismissal of Williams’ ADA lawsuit, arguing that the ADA excludes gender identity disorders that do not result from physical impairments. Alternatively, Williams argued that even if her gender dysphoria were synonymous with gender identity disorder, her gender dysphoria indeed resulted from physical impairments. Therefore, it would qualify as a disability under the ADA.

In Williams v. Kincaid, the Fourth Circuit held that Williams’ condition is not a gender identity disorder. The Fourth Circuit reasoned that the term “gender identity,” when the law was enacted, considered transgender status only and not gender dysphoria as a condition. In other words, the outdated guidance in 1990 considered being transgender a “disorder” in itself while yet recognizing gender dysphoria. Furthermore, the Fourth Circuit recognized that gender dysphoria could cause significant physical distress, among other impairments. In the end, the Fourth Circuit found that gender dysphoria does not fit the ADA’s exclusions and is, therefore, a qualifying disability.

Employer Takeaways

Although the Fourth Circuit’s ruling applies only to the states within its jurisdiction, employers must watch carefully for similar decisions within their own state. Indeed, this ruling sets a precedent that may be adopted in other circuit or higher courts. Additionally, both gender identity and disability are protected classifications under state and federal anti-discrimination laws.