The Medicalization Imperative: How Employment Discrimination Cases Reinforce Transnormativity

ABSTRACT This article argues that U.S. employment discrimination court decisions involving transgender plaintiffs reinforce transnormativity through medicalization, which sociologists recognize as a mechanism of social control. Drawing on a census of 124 state and federal cases from 1974 to 2021, I show how the medical imperative of transnormativity operate in court cases. Courts routinely introduce trans plaintiffs via surgical status or diagnosis, demand medical verification of identity, and interpret gender nonconformity as a condition requiring treatment. These practices reflect the broader sociological critique of medicalization as a strategy for managing deviance—shifting attention away from systemic inequality and toward individual pathology. By positioning gender variance within a diagnostic framework, courts depoliticize trans identities and reinforce transnormativity, the regulatory ideology that legitimizes only binary, medically transitioned trans people. This containment of gender deviance upholds hegemonic gender norms and reproduces a hierarchy of legitimacy among gender minorities. This study contributes to sociological understandings of medicalization by offering a case study of how legal institutions participate in the regulation of deviance, and to trans studies by empirically tracing how transnormativity operates within employment law. It also adds to the socio‐legal literature on the legal production and regulation of marginalized identities.