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In the first ruling on the issue by a federal appeals court, the 4th U.S. Circuit Court of Appeals in Richmond, Virginia, overturned a lower court ruling last week and held in a divided opinion that a transgender woman with gender dysphoria is entitled to protection under the Americans with Disabilities Act.
Kesha T. Williams, a transgender woman with gender dysphoria, spent six months incarcerated in the Fairfax County Adult Detention Center in Fairfax, Virginia, according to the Aug. 16 ruling by the 4th Circuit in Kesha T. Williams v. Stacey A. Kincaid et al.
Although she was initially assigned to women’s housing, prison deputies quickly moved her to men’s housing when they learned she was transgender, the ruling said.
There, she experienced delays in providing hormone treatment for her gender dysphoria, harassment by other inmates and “persistent and intentional misgendering and harassment” by prison deputies, including an invasive and painful body search, the ruling said.
After her release, Ms. Williams filed suit in U.S. District Court in Alexandria, Virginia, against the Fairfax County sheriff, a prison deputy and a prison nurse alleging violations of the ADA, the Rehabilitation Act, the U.S. Constitution, and state common law.
The district court dismissed the case. Sheriff Kincaid argues, and the district held, that the ADA’s exclusion for “gender identity disorders not resulting from physical impairments” applied to Ms. William gender dysphoria and barred her ADA claim, the ruling said.
Advances in medical understanding led the American Psychiatric Association in 2013 to remove “gender identity disorder” from its most recent Diagnostic Statistical Manual, it said.
The definition of gender dysphoria “differs dramatically from the now-rejected diagnosis of ‘gender identity disorder,’” the ruling said.
“Rather than focusing exclusively on a person’s gender identity,” the manual now defines “gender dysphoria” as the “'clinically significant distress’ felt by some of those who experience ‘an incongruence between their identity and their assigned sex,’” it said.
It reflected “a significant shift in medical understanding. The obsolete diagnosis focused solely on cross-gender identification; the modern one on clinically significant distress,” it said.
“In light of the broad scope of the ADA and the implementing regulations, we conclude that Williams has alleged sufficient facts to render plausible the inference that her gender dysphoria” resulted from physical impairments and is covered by the ADA, the majority ruling said.
“In particular, the need for hormone therapy may well indicate that her gender dysphoria has some physical basis,” it said, in reversing the district court’s dismissal of Ms. Williams ADA claims, reinstating gross negligence claims against the sheriff and deputy sheriff and remanding the case for further proceedings.
The dissenting opinion states that accepting Ms. Williams’ allegations as true “does not require me to turn a blind eye to the plain language of the authorities on which Williams relies”
Ms. Williams’ attorney, Joshua Erlich of the Erlich Law Office LLC in Arlington, Virginia, said in a statement that Ms. Williams “faced horrible treatment at the Fairfax County Adult Detention Center. We're thankful that the Fourth Circuit ruled in her favor and we are excited to get back into court to vindicate Kesha's rights.” The county’s attorney did not respond to a request for comment.
In June, a federal district court ruled that North Carolina’s health plan for state employees unlawfully discriminates by excluding treatments for transgender people by refusing to pay for hormone therapy and surgeries.