Fourth Circuit Rules that Gender Dysphoria Is Not Excluded from ADA Coverage

08.29.2022

The federal Fourth Circuit Court of Appeals recently ruled that gender dysphoria meets the definition of “disability” under the Americans with Disabilities Act (ADA) and does not fall within a specific exclusion in the ADA for certain “gender identity disorders.”

The case before the court of appeals involved claims brought by a transgender woman with gender dysphoria. The Diagnostic and Statistical Manual of Mental Disorders defines gender dysphoria as “clinically significant distress” felt by some of those who experience “an incongruence between their gender identity and their assigned sex.”  

The plaintiff was incarcerated in a Virginia jail. While there, she was moved to men’s housing, and she alleged that she was denied medical treatment for her gender dysphoria (in the form of hormone medications) and was harassed by jail officials. She brought numerous claims, including claims under the ADA.

The government argued that gender dysphoria was not a disability because the ADA excludes “transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, gender identity disorders not resulting from physical impairments, [and] other sexual behavior disorders” from the law’s protection.  The Fourth Circuit disagreed with this argument, finding that when the ADA was adopted, “gender identity disorders” did not include gender dysphoria. Thus, gender dysphoria was a covered disability, and did not fall within any exclusion.

Takeaway for Employers

This was a question of first impression in the federal circuit courts, and we may see future cases from other circuits addressing the same issue. For now, this case is binding in the Fourth Circuit, which covers Virginia, Maryland, North Carolina, South Carolina, and West Virginia.

It is also important to note that not all transgender or gender diverse people experience gender dysphoria. According to the Mayo Clinic, some transgender and gender diverse people “feel at ease with their bodies, with or without medical intervention.”  

So, like any other disability, accommodation and other requests should be evaluated on a case-by-case basis, and decisions should be based on an interactive dialogue with the employee and information from their medical provider.

Beyond transgender and gender diverse employees, this case serves as an important reminder that courts may construe ADA coverage broadly and, likewise, construe exceptions to coverage narrowly.

If you have questions about ADA coverage for your employees, reach out to your employment counsel at Hirschler.