Landmark Decision Extends ADA Protection to Individuals with Gender Dysphoria

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  • Landmark Decision Extends ADA Protection to Individuals with Gender Dysphoria

In the first such decision by a federal appellate court, the U.S. Court of Appeals for the Fourth Circuit ruled that the Americans with Disabilities Act (ADA) protects individuals with gender dysphoria. The decision, Williams v. Kincaid, No. 21-2030 (4th Cir. Aug. 16, 2022), has immediate consequences for employers in states within the jurisdiction of the Fourth Circuit: Maryland, North Carolina, South Carolina, Virginia, and West Virginia. Employers in California should heed this development, as the Ninth Circuit (and others) may follow suit.

The Case

Gender dysphoria is defined as psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity. The Williams case arises from the claim of a transgender woman, Kesha T. William, who alleges that she was wrongfully incarcerated among the male prison population, harassed and misgendered by prison staff and inmates, and denied accommodation and treatment for her gender dysphoria – all in violation of the ADA. At issue was whether gender dysphoria meets the definition of “disability” under the ADA, which is “a physical or mental impairment that substantially limits one or more major life activities of such individual.”

The Fourth Circuit drew a distinction between gender dysphoria and “gender identity disorder” (which is explicitly excluded from protection under the ADA) because gender dysphoria causes clinically significant distress and other disabling symptoms. The court cited specific studies that demonstrate how the effects of gender dysphoria can interfere with a person’s social life, ability to do their job, and other essential daily functions.

Impact on Employers

The impact on employers in the jurisdiction is simple but powerful: employees with gender dysphoria are entitled to ADA protection, including reasonable accommodation. This could include medical leaves of absence for treatment, restroom accommodations, and changes to work schedules and tasks. Regardless of whether an accommodation can be made without imposing an undue hardship, employers should conduct a good-faith interactive process and analysis of reasonable accommodations for employees with gender dysphoria, just as they would with any other ADA-protected disability. Employers should also be proactive in preventing and responding to any harassment and discrimination toward transgender and non-binary staff.

For more information about ADA protection and how we can assist you in ensuring your business is ADA-compliant, contact us at

This material is provided for informational purposes only. It is not intended to constitute legal advice, nor does it create a client-lawyer relationship between MNK Law and any recipient. Recipients should consult with counsel before taking any actions based on the information contained within this material.