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Williams v. Kincaid

United States Court of Appeals, Fourth Circuit
August 16, 2022

Keywords: Americans with Disabilities Act, ADA, Rehabilitation Act, Constitutional law, Equal Protection Clause, gender dysphoria, gender identity disorders, prison, transgender, gross negligence, statute of limitations,

Summary and Fact of the Case

Kesha Williams (“Williams”) is a transgender woman. People who are transgender see themselves, or express themselves, differently from the sex (male or female) they were assigned at birth. Williams was a male at birth.  She lived her life as a woman and legally changed her name. She also lived as a woman in her home state of Maryland.

Williams experiences gender dysphoria, a deep distress a person feels when their personal sense of gender and their sex assigned at birth do not match. Because of gender dysphoria, Williams has been treated for the past fifteen years with pills and injections.

Williams was sentenced to six months in a Virginia jail where she was originally assigned to female housing. She was then moved to male housing when her gender at birth was discovered during a medical examination.  During this check-up, Williams told the nurse that she has gender dysphoria. Williams asked to be given her prescribed pills and injections. The nurse asked her to fill out a release form and told her prison healthcare staff would follow up with her.

After being sent to male housing, Williams was denied access to her medications for gender dysphoria. This resulted in increased mental and emotional distress.

While Williams was on the men’s side of the prison, she faced repeated harassment by prison deputies about her sex and gender identity. Male inmates also bullied Williams. She feared for her safety. In January 2019, Williams was body searched by a male deputy, despite pleas that she be searched by a female. The search, performed by a man, led to painful bruising on Williams’ breast.

Williams filed a civil action for deprivation of rights against the Sheriff of Fairfax County, a prison deputy, and a prison nurse, charging violations of the Americans with Disabilities Act (“ADA”), the Rehabilitation Act of 1973, the United States Constitution, and state common law.

After learning the names of the other two prison employees, and two months after filing the initial complaint, Williams filed a revised complaint, naming Sheriff Kincaid, Nurse Wang, and Deputy Garcia.

Williams’ case was dismissed in district court.  The court said that some of Williams’ charges were not well argued and that other charges were not allowed because the time had run out to argue them.  Williams appealed this decision to the Fourth Circuit Court of Appeals.

The Fourth Circuit reversed the lower court’s decision and ruled in Williams’ favor.

Issues of the Case

  1. Does the ADA’s exclusion for “gender identity disorders not resulting from physical impairments” apply to Williams’ gender dysphoria and bar her ADA claim?
  2. Were Williams’ claims against Nurse Wang and Deputy Garcia are barred by the statute of limitations?

Arguments and Analysis

1. Williams argued that gender dysphoria is not a gender identity disorder and that, even if it is, it is caused by a physical issue placing it under the protection of the ADA.

Sheriff Kinkaid’s argument relied on ADA exclusions. He claimed that the exclusion for “gender identity disorders not resulting from physical impairments” applied to Williams’ gender dysphoria and prevented her ADA claim. The District Court agreed.

However, Williams argued that gender dysphoria is not a gender identity disorder. Williams indicated that the ADA specifically lists exclusions from the definition of “disability,” but gender dysphoria is not listed. This argument led the court of appeals to study whether the term “gender identity disorders” includes gender dysphoria. The court cited the American Psychiatric Association (APA), that said that gender dysphoria is the distress a person feels when their personal sense of gender and their sex assigned at birth do not match. This is not the same as a gender identity disorder not resulting from physical impairment.

The court of appeals decided that gender dysphoria “concerns itself primarily with distress and other disabling symptoms, rather than simply being transgender”.  The court found nothing in the ADA to exclude gender dysphoria from protection. Additionally, in this finding, the court relied on the Americans with Disabilities Amendments Act 2008 (ADAAA). The ADAAA states that disability is to be understood broadly to increase protections given to individuals with disabilities.

Williams also argued that, even if gender dysphoria is a gender disorder, it results from a physical basis, placing it under the ADA protection. In response to this, Sheriff Kinkaid argued that Williams failed to clearly allege that her gender dysphoria was the result of a physical impairment. The district court based its decision on this argument alone.

However, the Court of Appeals, relying on the ADAAA, found that Williams gave enough facts to persuade the court that her gender dysphoria results from physical impairments.

Finally, the Court of Appeals indicated that, under the Equal Protection Clause of the 14th Amendment, a law that would exclude gender identity disorders and gender dysphoria from ADA protection would discriminate against transgender people as a class and would be unconstitutional.

2. Williams argued that, under Rule 15(c) of the Federal Rules of Civil Procedure, her claims against Nurse Wang and Deputy Garcia should be allowed.

Although Williams did not initially name Nurse Wang and Deputy Garcia in her first complaint, she did file an amended complaint. She argued that the revised complaint “related back” to the original complaint. Therefore, the date of the original complaint applies to all her claims.

Under Rule 15(c), a change to a pleading that replaces or renames a party, “relates back” to the original pleading when:

  1. the change resulted from the same “conduct, transaction, or occurrence” as the original pleading;
  2. the change is made within the period set out for serving the summons and complaint,” and the new party receives notice of the action in a timely manner (Rule 4(m), and;
  3. the newly named party “knew or should have known that the action would have been brought against it, but for a mistake concerning the proper party’s identity.” Fed. R. Civ. P. 15(c)(1)(B)–(C).

The district court focused only on the second part of Rule 15(c) and decided that, because Williams received an extension from the court, she did not file the amended complaint within the 90-day requirement and did not give timely notice to the Defendants.

The Court of Appeals, however, believed that the district court made a mistake by not including the court-approved extension. Because Williams was granted a court-extension and filed the revised complaint within the court-granted timeline, she was within the bounds of Rule 15(c). Therefore, her claims should be allowed.


The United States Fourth Circuit Court of Appeals ruled that Williams reasonably argued that gender dysphoria is protected under the ADA and does not fall within the ADA’s exclusion for “gender identity disorders not resulting from physical impairments.”  The case was sent back to the district court for further proceedings.

The Court also decided the amended complaint related back to the original complaint. The case should not have been dismissed as Williams adequately stated claims of gross negligence against Sheriff Kincaid and Deputy Garcia.

Policy and Practice

The ADAAA (2008) calls for a broad interpretation of the law in order to give broad protections to individuals with disabilities and should be understood as such in a court of law. Additionally, courts must consider all four factors when determining relation back under the Federal Rules of Civil Procedure, and court-ordered extensions are to be considered.



These materials do not constitute legal advice and should not be relied upon in any individual case. Please consult an attorney licensed in your state for legal advice and/or representation. These materials were prepared by the legal research staff of the Burton Blatt Institute (BBI) at Syracuse University in partnership with the Southeast ADA Center to highlight legal and policy developments relevant to civil rights protections and the impact of court decisions in the Southeast Region under the Americans with Disabilities Act (ADA). These materials are based on federal disability rights laws and court decisions in effect at the time of publication. Federal and state disability rights law can change at any time.  In addition, state and local laws and regulations may provide different or additional protections. Materials are intended solely as informal guidance, and are neither a determination of your legal rights nor responsibilities under the ADA or other federal, state, and local laws, nor binding on any agency with enforcement responsibility under the ADA. The accuracy of any information contained herein is not warranted. Any links to external websites are provided as a courtesy and are not intended to nor do they constitute an endorsement of the linked materials.