RICHMOND, Va. (AP) — In a win for transgender rights, the U.S. Supreme Court on Friday declined to review a first-of-its-kind ruling from a federal appeals court that found people with gender dysphoria are entitled to the protections of the Americans With Disabilities Act.
Advocates praised the decision to leave a ruling from the 4th U.S. Circuit Court of Appeals in place.
"By declining to hear this case, the Supreme Court implicitly acknowledges what those who have seriously examined the issue have concluded: the ADA protects people who experience gender dysphoria, including transgender and nonbinary people, from being discriminated against on that basis," said Olivia Hunt, policy director for the National Center for Transgender Equality.
But in a scathing dissent, Justice Samuel Alito said he found "several aspects" of the 4th Circuit's reasoning in the case "troubling" and said the ruling "will raise a host of important and sensitive questions" on participation in women's and girls' sports, the use of traditional pronouns and sex-reassignment therapy by physicians who object to such treatment on religious or moral grounds.
In its August 2022 ruling, the 4th Circuit became the first federal appellate court in the country to find the 1990 landmark disabilities law protects transgender people who experience anguish and other symptoms as a result of the disparity between their assigned sex and their gender identity.
Under the ruling, people with gender dysphoria are entitled under the ADA to receive reasonable accommodations and are protected from discrimination. Advocates see the ruling as a tool they can use to challenge legislation in a growing number of states aimed at restricting access to gender-affirming medical care and other accommodations for transgender people.
"The overwhelming majority of Americans support nondiscrimination protections for LGBTQIA+ people, and today's decision means the ADA remains a mechanism that can help our communities secure those protections," Hunt said.
The ruling is binding only in the states covered by the Richmond-based 4th Circuit — Maryland, North Carolina, South Carolina, Virginia and West Virginia.
The decision came in the case of Kesha Williams, a transgender woman who sued the Fairfax County sheriff in Virginia.
Williams told the jail's nurse she has gender dysphoria and received hormone treatments for the previous 15 years. She was initially assigned to live on the women's side of the jail, but after she explained she had not had genital surgery, she was assigned to the men's section under a policy that inmates must be classified according to their genitals, her lawsuit said.
Williams said she was harassed and that her prescribed hormone medication was repeatedly delayed or skipped. Her requests to shower privately and for body searches to be conducted by a female deputy were denied, she said.
A federal judge dismissed the lawsuit, finding that because the Americans with Disabilities Act excluded "gender identity disorders not resulting from physical impairments," Williams could not sue under the law.
A three-judge panel of the 4th Circuit reversed that ruling, finding there is a distinction between gender identity disorder and gender dysphoria. The court cited advances in medical understanding that led the American Psychiatric Association to remove gender identity disorder from the current Diagnostic and Statistical Manual of Mental Disorders and to add gender dysphoria, defined in the manual as the "clinically significant distress" felt by some transgender people. Symptoms can include intense anxiety, depression and suicidal ideation.
Alito, who was joined in his dissent by Justice Clarence Thomas, said he was in favor of having the high court review the ruling.
"The Fourth Circuit's decision makes an important provision of a federal law inoperative and, given the broad reach of the ADA and the Rehabilitation Act, will have far-reaching and important effects across much of civil society in that Circuit," Alito wrote.
"Voters in the affected States and the legislators they elect will lose the authority to decide how best to address the needs of transgender persons in single-sex facilities, dormitory housing, college sports, and the like."
Casey Lingan, general counsel for the Fairfax County Sheriff's Office, declined to comment on the high court's decision, noting WIlliams' lawsuit is still pending.
Katherine Hermann, an attorney for Williams, said Williams is excited to have the chance to continue litigating her case in court. Hermann said Alito's dissent "understates the seriousness of gender dysphoria and the importance of ensuring the protections of the ADA apply equally to everyone, regardless of their gender identity."