Fourth Circuit holds that gender dysphoria can sometimes constitute a disability protected by the ADA

In Williams v. Kincaid, the Fourth Circuit held that, while being transgendered itself is not a disability protected by the ADA (Americans with Disabilities Act), gender dysphoria can sometimes be. The Fourth Circuit summarized 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.” The court noted, “People suffering from gender dysphoria often benefit from medical treatment, including hormone therapy,” and observed that “gender dysphoria” is “a disability suffered by many (but certainly not all) transgender people” (parenthetical in original).

Accordingly the Fourth Circuit cautioned that not all transgendered people suffer a “disability” protected by the ADA, and neither do all transgendered individuals who suffer from gender dysphoria. Rather, the ADA protects only those individuals whose gender dysphoria is so severe as to render them “disabled” within the meaning of the ADA. The court found significant that this plaintiff had required daily hormone treatment for 15 years due to gender dysphoria. Based on the plaintiff’s allegations to that effect, the court held this plaintiff should be entitled to try to prove that her gender dysphoria constituted a “disability” as defined by the ADA, in other words, a physical impairment that substantially limits one or more of her major life activities . (Note: The ADA also protects mental impairments that are so limiting, but this case involved allegations that the plaintiff’s gender dysphoria was a physical impairment; there was no issue raised regarding mental impairment.)

The dissent noted that the ADA, when passed, expressly excluded from protected disabilities “gender identity disorders,” but the majority held that whatever the phrase “gender identity disorders” meant “at the time of (the ADA’s) enactment,” it did not include gender dysphoria and, even if it did, the case was at too premature a stage to determine that this particular plaintiff’s gender dysphoria was a “gender identity disorder.”