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Employment Law Alert – Fourth Circuit Holds Gender Dysphoria is Protected Under the ADA

September 7, 2022

On August 16, 2022, the U.S. Court of Appeals for the Fourth Circuit held that gender dysphoria is a disability under the Americans with Disabilities Act (“ADA”).  The World Professional Association for Transgender Health Standards of Care defines “gender dysphoria” as a “discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth.”  In Williams v. Kincaid, the court reversed the lower court’s dismissal of a lawsuit filed by the plaintiff, a transgender woman, who during her 6 months in prison experienced delayed medical treatment for her gender dysphoria and harassment by other inmates and prison employees.  The plaintiff claimed, among other things, that the prison violated the ADA by discriminating against her on the basis of her gender dysphoria.  The lower court dismissed the lawsuit after concluding that the ADA’s definition of “disability,” which expressly excludes “gender identity disorders not resulting from physical impairments,” also excludes gender dysphoria.

The Fourth Circuit held that the ADA could cover gender dysphoria for three reasons.  First, the court found that the legislative history behind the ADA’s exclusion of “gender identity disorders not resulting from physical impairments” focused on being transgender.  The court explained that transgender and gender dysphoria are different because gender dysphoria primarily concerns itself with distress and other disabling symptoms.  Second, the court explained that gender dysphoria can result from physical impairments.  The court found that the plaintiff’s need for hormone therapy may indicate that her gender dysphoria has some physical basis.  The court also noted that there is medical and scientific research identifying possible physical bases of gender dysphoria.  Finally, the court held that a law excluding from ADA protection both gender identity disorders and gender dysphoria would discriminate against transgender people as a class, implicating the Equal Protection Clause of the Fourteenth Amendment.  The court stated that the only reason Congress would do so was “a bare desire to harm a politically unpopular group, which cannot constitute a legitimate governmental interest.”

It is important to note that although this decision is not about employment, the court’s holding will also apply in employment-related cases.


The contents of this Alert are for informational purposes only and do not constitute legal advice. If you have any questions about this Alert, please contact the Shulman Rogers attorney with whom you regularly work or a member of the Shulman Rogers Employment and Labor Law Group.

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