Gender Dysphoria Covered Under Disability Law, Federal Court Rules

Gender Dysphoria Covered Under Disability Law, Federal Court Rules

Gender dysphoria is protected under the Americans with Disabilities Act (ADA) and the Rehabilitation Act, a federal panel ruled last week.

The U.S. Court of Appeals for the Fourth Circuit issued the landmark decision August 16 on the Williams v. Kincaid case, which became the first federal appellate court in the nation to find that the 1990 landmark federal law should include peopel who experience “discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth,” according to the filings.

Judge Diana Gribbon Motz wrote in the majority opinion that a gender dysphoria diagnosis “affirms that a transgender person’s medical needs are just as deserving of treatment and protection as anyone else’s.”

Kesha Williams, the plaintiff, sued the Fairfax County sheriff, a prison deputy, and a prison nurse in Virginia, alleging violations against the ADA and Rehabilitation Act after authorities released Williams from a men’s correctional facility. Williams, born as a biological male, began receiving medical treatment for gender dysphoria 15 years before his incarceration.

Williams was initially assigned to the women’s side of the Fairfax County jail when he arrived in 2018. Still, authorities moved Williams to the men’s section after explaining to the nurse that Williams identified as transgender, but had not undergone genital surgery.

The plaintiff sued the county jail based on “experienced delays in medical treatment for her gender dysphoria, harassment by other inmates, and persistent and intentional misgendering and harassment by prison deputies” while spending six months in the detention center.

Defendants in the case appealed that the ADA afforded Williams no basis for relief because “gender dysphoria is not a ‘disability’ under the ADA” and “it is an identity disorder not resulting from physical impairments.” 

When Congress enacted ADA in 1990, it defined the term “disability” as “a physical or mental impairment that substantially limits one or more major life activities of such individual.” However, the law excluded defining “gender identity disorders.” The appeals court held that the term should be understood as “at the time of its enactment.”

However, the definition changed in 2013 when the Fourth Circuit noted that “gender identity disorder” had been removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) and added gender dysphoria, which means that someone with an “incongruence between their assigned gender identity and assigned sex” may experience “clinically significant distress.”

Williams argued that gender dysphoria was not a gender identity disorder and, even if it were, that “it results from a physical basis that places it outside the scope of the exclusion and ADA protection.”

Littler, a law firm focused on labor and employment laws, said that the Fourth Circuit’s decision could have broad implications for employers in Maryland, North Carolina, South Carolina, Virginia, and West Virginia.

“Under this decision, employees experiencing gender dysphoria are entitled to the protections of the ADA, including reasonable accommodation,” the firm reports.

Such accommodations would include a request for “gender dysphoria could conceivably arise for restroom usage, employer-provided housing, task and shift assignments, and leaves of absence for medical treatment,” adding employees would be protected from any discrimination, harassment, and retaliation based on gender dysphoria under the ADA.

Judge A. Marvin Quattlebaum Jr. dissented in part, writing, “whether we focus on when Congress passed the ADA or look beyond to today, the distinction Williams attempts to draw between gender identity disorder and gender dysphoria fails.”

The defendants may seek further review from the U.S. Supreme Court.