The dispute started when Kesha Williams was sentenced to 6 months' incarceration at a Fairfax County, Virginia, Adult Detention Center. Williams was first placed with female inmates, however she was transferred to a male facility once prison deputies, represented in the case as defendant Deputy Stacey Kincaid, discovered she was transgender.

From there, the complaint alleges, Williams was denied treatment for her gender dysphoria and harassed by fellow inmates and prison staff.

She challenged her treatment as a violation of the ADA in federal court but the case was thrown out when Eastern District of Virginia District Court Judge Claude M. Hilton said exceptions in the ADA, added in 2008, precluded transgender people from protection as it "is an identity disorder not resulting from physical impairments."

Sections of the 2008 code amendment include "transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, gender identity disorders not resulting from physical impairments, or other sexual behavior disorders" in a list of exceptions in the law.

But Motz found the listed exceptions were too broad to allow for such exclusions when faced with the law's purpose to protect those with disabilities.

"Williams does not merely allege that gender dysphoria may require physical treatment such as hormone therapy; she maintains that her gender dysphoria requires it," wrote the appeals judge, who noted Williams' need for hormone therapy was mentioned 10 times in her complaint. "That Williams did not 'specifically allege that her gender dysphoria is rooted in some physical component' by using those particular words does not render implausible the inference that her gender dysphoria has a physical basis."

Arlington, Virginia-based Attorney Joshua Erlich, who represented Williams, praised the appeals court ruling.

"Kesha Williams faced horrible treatment at the Fairfax County Adult Detention Center," he said in a statement. "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."

Attempts to solicit comment from Cook Craig & Francuzenko attorney Alexander Francuzenko, who represented Kincaid, were not returned.

Still, Judge A. Marvin Quattlebaum Jr., in a dissenting opinion, said the majority was too quick to reinterpret language within the ADA.

"If Williams is correct about such changes in understanding, linguistic drift cannot alter the meaning of words in the ADA when it was enacted," he wrote.

Quattlebaum, a Donald Trump appointee, instead compared the "linguistic drift" to Lewis Carroll's "Through the Looking-Glass, And What Alice Found There."

"Accepting [Williams'] allegations as true does not require me to turn a blind eye to the plain language of the authorities on which Williams relies. Nor does it permit Williams, like Humpty Dumpty, to 'use a word' and declare 'it means just what I choose it to mean.'" he wrote. "After all, we are not in Wonderland."

Despite such concerns, LGBTQ-rights focused attorneys at Lambda Legal say the Fourth Circuit's decision, the first to link gender dysphoria with ADA protections, will have a wide impact on the community.

"People living with gender dysphoria have a disability as defined by the ADA and have the protections under the act," said Lambda Legal Senior Attorney Richard Saenz, who authored an amicus brief supporting Williams in the dispute. "More people are familiar with ADA in the context of accommodations, but I think this case shows, even in the jail context, similar gender dysphoria ADA claims are viable."

Craig Konnoth, professor of law at the University of Virginia School of Law, said transgender-related ADA claims had been floating around for about seven years with a few important court wins. And while he was pleased with Tuesday's ruling, he said he didn't expect an explosion of litigation using the new precedent.

"Transgender plaintiffs may often allege a sex discrimination claim, but in some contexts—such as prisons–sex discrimination is permitted," he said. "Sex discrimination claims also does not provide remedies that the ADA does, such as accommodations."

Between Title VII and Title XI, two civil rights laws which cover sex discrimination, and the lawyer payment provisions those statutes offer vs. ADA, he said the ruling for Williams will be more important qualitatively than quantitatively.

"I don't expect a massive explosion of claims under the ADA," he said. "[Transgender supportive ADA opinions] might be important, but they'll be more important in the scope of argumentation, but not numerically."

Editor's Note: The insurance industry is one of the industries that are most affected by the multifaceted requirements and implications of the ADA. Not only are insurance companies required to comply with ADA provisions related to employment and accommodating the public, insurers must also inform clients of the effect of insurance coverage on ADA-related claims and lawsuits, and assess the impact of the ADA on workers' compensation.