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4th Circuit recognizes gender dysphoria as a disability under ADA

March 2023 employment law letter
Authors: 
Emily L. Matta, Foulston Siefkin LLP

The U.S. 4th Circuit Court of Appeals (whose rulings apply to employers in Maryland, North Carolina, South Carolina, Virginia, and West Virginia) became the first federal appellate court to rule that gender dysphoria is a disability under the Americans with Disabilities Act (ADA) and the Rehabilitation Act, joining a small but growing number of district courts.

Employers operating in the 4th Circuit may have to provide reasonable accommodations for employees with gender dysphoria. Although the decision isn’t binding in the 8th Circuit (which includes Arkansas and Missouri) or the 10th Circuit (which includes Kansas and Oklahoma), employers should keep an eye on emerging caselaw and consider consulting an attorney if an employee requests an accommodation because of gender dysphoria.

What is gender dysphoria?

Gender dysphoria is a medical condition recognized by the American Psychiatric Association (APA) that some, but not all, people who are transgender may experience. The APA defines gender dysphoria as clinically significant “psychological distress that results from the incongruence between one’s sex assigned at birth and one’s gender identity.”

Treatment for gender dysphoria may range from forms of social affirmation of the individual’s gender identity—for example, using the person’s chosen pronouns and name—to medical affirmation, including hormone treatment or surgery.

4th Circuit’s opinion

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