Client Alerts & Insights
Gender Dysphoria Protected by the ADA, Per Fourth Circuit
August 19, 2022
Authored By:
Recent case law continues to develop the scope of legal protections for transgender individuals. One month after a Texas court enjoined the Equal Employment Opportunity Commission (“EEOC”) from enforcing its 2021 guidance protecting transgender individuals, the Fourth Circuit has recognized gender dysphoria as a disability protected by the Americans with Disability Act (“ADA”).
In Williams v. Kincaid, Kesha Williams, a transgender woman with gender dysphoria, filed suit against the Sheriff of Fairfax County alleging violations of the ADA stemming from her treatment as an inmate at a Virginia detention center. Williams was housed in the men’s unit of the facility, faced delayed access to her prescribed hormone therapy medication, and was denied various accommodations she had requested relating to her gender dysphoria. The district court dismissed her claim, holding that it failed to state grounds for relief and that gender dysphoria is not a disability under the ADA.
The Fourth Circuit reversed. Although the statutory text of the ADA excludes “gender identify disorders not resulting from physical impairments” from the statutory definition of disability, the court concluded that gender dysphoria is different than gender identity disorder. Gender dysphoria is defined as the “clinically significant distress” felt by individuals who experience incongruity between their gender identity and assigned sex. Gender dysphoria is thus categorized by extreme distress. In addition, it may result from a physical impairment, with the need for hormone therapy indicative of a physical basis for the condition. Thus, Williams’ claims survived a motion to dismiss.
While this ruling focused on Title II of the ADA regarding government services, its impact may be felt by employers, particularly those operating within the Fourth Circuit. Employers are already prohibited from discriminating against employees based on gender identity, but the Williams decision indicates that employers may also need to grant accommodations to such employees if they suffer from gender dysphoria. Employers in the Fourth Circuit should, therefore, treat requests for accommodation based on gender dysphoria in the same manner as any other disability-related request for accommodation.
Although it is unclear if other circuits follow the Fourth Circuit, this decision provides insight into what may lie ahead. Employers should evaluate their current policies. For more information, please contact a member of Benesch’s Labor & Employment Practice Group.
Adam Primm at aprimm@beneschlaw.com or 216.363.4451.
Latest News
The Coming State-Law Litigation Wave of 2026-27: “Subscription Trap” Class Actions
The subscription economy keeps growing—and so does the wave of class-action litigation targeting it. While the FTC’s regulatory efforts have drawn headlines, private class actions under state laws pose an even greater exposure risk.
Updates to Fees and Grace Periods for Nonimmigrant Visas
Starting September 9, 2026, the 9-11 Response Biometric Entry-Exit Fee will apply to H-1B and L-1 extension petitions filed by employers subject to the fee. Prior to the new rule, the fee was only required for (1) initial grant of status to a foreign national seeking H-1B or L-1 status and (2) a change of employer in the same status.
Third Circuit Decision Reshapes Creditor Standing in Successor Liability Disputes
The Third Circuit recently held that when determining whether a successor liability claim belongs to a bankruptcy estate, the key question is whether the claim seeks to remedy harm suffered by all creditors collectively or a unique injury suffered by a specific creditor. The fact that creditors may be permitted to bring the claim outside of bankruptcy is not, by itself, determinative.
CMS Proposes Sweeping Restrictions on Remote Patient Monitoring: The Outsourcing Ban, Reimbursement Revaluation and Potential Code Consolidation in the CY 2027 Physician Fee Schedule Proposed Rule
CMS’s CY 2027 Proposed Rule would significantly restrict Medicare reimbursement for Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM), including banning outsourced clinical staffing, adding new patient-relationship and initiating-visit requirements, reducing certain reimbursement rates, and exploring consolidation of existing billing codes.