RICHMOND, Va. (AP) — A federal appeals court on Friday denied a request to rehear a case that found that gender dysphoria is a condition covered by the Americans with Disabilities Act.

In August, a three-judge panel of the Richmond-based 4th U.S. Circuit Court of Appeals became the first federal appellate court in the country to find that the landmark federal law protects people with gender dysphoria, a condition that causes anguish and other symptoms as a result of a disparity between a person’s gender identity and their assigned sex at birth.

The decision came in the case of Kesha Williams, a transgender woman who sued the Fairfax County sheriff in Virginia for housing her in a jail with men under a policy that inmates must be classified according to their genitals.

In her lawsuit, Williams said that she was harassed and that her prescribed hormone medication was repeatedly delayed or skipped, violating the Americans with Disabilities Act.

A federal judge granted a motion by the sheriff’s office to dismiss the lawsuit, but the 4th Circuit panel reversed that ruling, finding there is a distinction between gender identity disorder and gender dysphoria.

The modern diagnosis of gender dysphoria “affirms that a transgender person’s medical needs are just as deserving of treatment and protection as anyone else’s,” Judge Diana Gribbon Motz wrote in the opinion.

On Friday, the 4th Circuit rejected a request from the sheriff’s office for the full court of 15 judges to rehear the case.

The sheriff’s office did not immediately respond to a phone message seeking comment, and attorneys for the sheriff’s office did not respond to an email.