Trans Resource Navigator

Gender-affirming care in South Carolina

Care for adults
Limited
Care for people under 18
Banned
Healthy Connections Medicaid pays for hormones
Not covered
Healthy Connections Medicaid pays for surgery
Not covered
Private plans must cover care
No state rule

Adults in South Carolina can still legally get hormone therapy, including from Planned Parenthood and telehealth, but since May 2024 state law bars any public funds from paying for it at any age, so Medicaid and the state employee health plan do not cover it. Puberty blockers, hormones, and surgery for gender transition are banned for everyone under 18. A federal lawsuit (Misanin v. Wilson) is pending, but the law is in effect. South Carolina has no shield law.

Draft from official sources, September 24, 2026. Not yet checked by a person. How we verify

On this page
  1. If you are under 18, or a parent
  2. Rules for adults
  3. Health centers near you
  4. Hormones by telehealth
  5. Clinics, programs, and funds
  6. Paying for care
  7. Laws and court cases
  8. Sources

If you are under 18, or a parent

Banned since May 21, 2024 (Act 203, H 4624; S.C. Code §§ 44-42-310 to -360). Physicians, mental health providers, and other health care professionals may not provide puberty blockers, cross-sex hormones, or gender reassignment surgery to anyone under 18. Young people already on blockers or hormones before August 1, 2024 could be tapered off only until January 31, 2025; that window has closed.

Exceptions: care for precocious puberty, certain cancers, endometriosis, differences of sex development, complications of earlier transition care, and emergencies. Mental health care remains legal.

Penalties: licensing board discipline; lawsuits by the patient until 21 years after turning 18, with attorney's fees; enforcement by the Attorney General; and a physician who performs genital surgery on a minor is guilty of inflicting great bodily injury on a child.

Schools: public school staff may not withhold from parents that a student's gender identity differs from their sex, and the principal, vice principal, or counselor must notify parents in writing if a student says so or asks to be called by a different pronoun (§ 59-32-36).

The ban is in effect. It is challenged in Misanin v. Wilson (federal court, filed August 2024), but no court has blocked it, and the US Supreme Court upheld Tennessee's similar ban in June 2025. Families can get navigation help and travel grants for out-of-state care from the Campaign for Southern Equality's Trans Youth Emergency Project.

[1][2][3][4][10]

Rules for adults

Hormone therapy and surgery are legal for adults 18 and older, but Act 203 of 2024 (H 4624) limits who pays:

  • No public funds, at any age (S.C. Code § 44-42-340). This covers Medicaid, the State Health Plan for public employees, and other state money. The ACLU of South Carolina reports that after the law passed, adults on Medicaid, on the state employees' plan, and at the Medical University of South Carolina (MUSC) had appointments canceled.
  • Medicaid may not cover anything the chapter prohibits (§ 44-42-350).

If you have no insurance or only Medicaid, in rough order of what to try:

  1. Planned Parenthood South Atlantic lists gender-affirming care at its Columbia and Charleston health centers and by video visit for South Carolina residents. Call to confirm age and cost.
  2. Telehealth: Plume, FOLX, and QueerMed serve South Carolina. Point of Pride's HRT Access Fund pays for 18 months of telehealth care through partners like these.
  3. Private insurance you buy yourself or get through a private employer is not covered by the public-funds ban, but South Carolina does not require plans to cover transition care, so check your policy.
  4. Community health centers charge on a sliding scale; find one at findahealthcenter.hrsa.gov and ask whether they prescribe hormones and whether state money limits them.
  5. Generic estradiol and spironolactone are inexpensive with a pharmacy discount coupon; compare cash prices for testosterone.
[1][2][3][5][6][9][8][18]

Community health centers near you

These federally funded centers must see you whether or not you have insurance, and charge based on income. Many, but not all, prescribe hormone therapy. Call and ask for "gender-affirming care" or "hormone therapy."

Sorting by distance uses your location only on this device. It is never sent anywhere.

Hormones by telehealth

These services prescribe hormones through video visits for people in this state. Point of Pride pays for a year and a half of care with several of them each spring.

  • Plume

    PaidNo Medicaid18+

    Trans-led telehealth service providing informed-consent hormone therapy, lab orders, prescriptions, and letters for surgery and documents, by app and video visit. Self-pay only since January 2026. A Point of Pride HRT Access Fund partner.

    About $99 per month ($90 in NY and NJ), which includes visits, messaging, prescriptions, and document letters. Labs and medications are billed separately and are often cheap with GoodRx or at a community pharmacy. Free for 18 months if you win a Point of Pride HRT Access Fund grant.

  • FOLX Health

    InsuranceTakes insuranceNo Medicaid18+

    LGBTQ-focused telehealth offering hormone therapy, PrEP, primary care, and mental health visits. Accepts major commercial insurance (Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare) but not Medicaid or Medicare. A Point of Pride HRT Access Fund partner.

    In-network with many commercial plans; self-pay membership about $69 to $98 per month all-inclusive.

  • Planned Parenthood

    Sliding scaleTakes insurance

    Many Planned Parenthood affiliates provide informed-consent gender-affirming hormone therapy alongside sexual and reproductive health care, on a sliding scale and with Medicaid. Most affiliates see adults 18 and older; a few see 16- and 17-year-olds with parental consent and a readiness letter. Many start hormone care by telehealth. Self-pay initial consults typically run about $120 to $250 before sliding-scale discounts.

Clinics, programs, and funds

  • Planned Parenthood South Atlantic (Columbia and Charleston health centers, video visits)[5][6][7]

    Lists Gender-Affirming Care, PrEP, HIV services, and STI testing at its Columbia (2712 Middleburg Dr, Suite 107; 803-256-4908) and Charleston (1312 Ashley River Rd; 843-628-4380) health centers, plus video visits for South Carolina residents. Book online or at 1-800-230-PLAN. Adults 18+ only under state law; confirm cost and informed-consent approach when you call.

    • Cost varies
    • Telehealth
    1-800-230-7526

  • QueerMed[8]

    Telehealth gender-affirming hormone care for trans and nonbinary adults; lists South Carolina among its states. Insurance and self-pay options.

    • Cost varies
    • Telehealth

  • Point of Pride HRT Access Fund[9]

    Pays for 18 months of telehealth hormone care (visits, labs, and letters) through partners including Plume, FOLX, and QueerMed, for people 18 and older.

    • Free

  • Campaign for Southern Equality, Trans Youth Emergency Project[10]

    For families of trans youth in states with bans. One-on-one patient navigation to out-of-state care and emergency travel grants.

    • Free
    • Community reported

  • CAN Community Health, Columbia[11]

    HIV care, PrEP, free rapid HIV and hepatitis testing, STI testing and treatment, counseling, and pharmacy in downtown Columbia.

    • Cost varies
    803-849-84301911 Hampton St., Columbia, SC 29201

  • Palmetto Community Care[12]

    North Charleston HIV services organization offering in-office PrEP, PrEP by telehealth, PEP, doxyPEP, at-home HIV test kits, and case management, with LGBTQ+ inclusive and gender-affirming care.

    • Cost varies
    • Telehealth
    843-747-22735064 Rivers Avenue, North Charleston, SC 29406

  • SC Thrive[14][13]

    Free help applying for Medicaid and other benefits in South Carolina. SCDHHS refers applicants here.

    • Free
    800-726-8774

  • A4TE Trans Health Project[17]

    Free help appealing insurance denials for gender-affirming care, with templates and guides.

    • Free

  • HRSA Find a Health Center[18]

    Federal search tool for community health centers, which charge on a sliding scale based on income.

    • Sliding scale

Paying for care

Medicaid (Healthy Connections Medicaid)[1][3][13][14]

Section 44-42-340 bars public funds for gender transition procedures at any age, and § 44-42-350 bars Medicaid from covering practices the chapter prohibits. The ACLU reports Medicaid patients lost care after the law passed. Medicaid still covers other health care, including primary care, labs, mental health, and PrEP.

Who qualifies: South Carolina has not expanded Medicaid. Adults generally qualify only if they are 65+, blind, or disabled (about 100% of the poverty level, $1,330 a month for one person as of March 2026), pregnant, or a low-income parent or caretaker. If you are unsure, apply anyway; Healthcare.gov forwards eligible applications to SCDHHS. SC Thrive helps with applications for free.

Apply for coverage

Private insurance[16][15][17]

South Carolina has no law stopping private insurers from excluding gender-affirming care. Private plans are not bound by the public-funds ban, but may exclude transition care; read your policy's exclusions. If a claim is denied, appeal with the insurer first (A4TE's Trans Health Project has free templates), then file a complaint with the SC Department of Insurance.

File an insurance complaint

The rules in detail

Laws and court cases1 court case, 2 laws

Misanin v. Wilson, No. 2:24-cv-04734-BHH

No injunction has been issued. All three provisions are in effect while the case continues.[3]

Three trans adults and two families of trans youth, represented by the ACLU, ACLU of South Carolina, and Selendy Gay, challenge the ban on care for minors, the public-funds ban (at any age), and the Medicaid exclusion under the Equal Protection Clause and federal anti-discrimination laws. Last update 2024-08-29.

Sources

18 sources. Numbers in the text, like [1], point here.Show all
  1. S.C. Code Title 44, Chapter 42, Article 3, Gender Reassignment ProceduresSouth Carolina Legislature, Law. accessed
    “Public funds may not be used directly or indirectly for gender transition procedures.”
  2. H 4624 (2024), ratified text, Act No. 203South Carolina Legislature, Law. accessed
    “This act takes effect upon approval by the Governor. Ratified the 15th day of May, 2024. Approved the 21st day of May, 2024.”
  3. Misanin v. WilsonACLU of South Carolina, Organization. accessed
    “adults who were receiving gender-affirming care on Medicaid, on the state employees' health insurance plan, and at the Medical University of South Carolina began receiving notice that their appointments were canceled”
  4. United States v. Skrmetti, No. 23-477 (June 18, 2025)Supreme Court of the United States, Court. accessed
  5. Virtual Health CenterPlanned Parenthood South Atlantic, Organization. accessed
    “Video visits are available to residents of North Carolina, South Carolina, Virginia, and West Virginia.”
  6. Columbia Health CenterPlanned Parenthood South Atlantic, Organization. accessed
    “Services: Gender-Affirming Care; HIV Services; STD Testing and Treatment”
  7. Charleston Health CenterPlanned Parenthood South Atlantic, Organization. accessed
    “Services: Gender-Affirming Care; HIV Services; STD Testing and Treatment”
  8. LocationsQueerMed, Organization. accessed
  9. HRT Access FundPoint of Pride, Organization. accessed
  10. Trans Youth Emergency ProjectCampaign for Southern Equality, Organization. accessed
  11. CAN Community Health, South CarolinaCAN Community Health, Organization. accessed
  12. Palmetto Community CarePalmetto Community Care, Organization. accessed
    “LGBTQ+ inclusive and gender-affirming care”
  13. Program Eligibility and Income LimitsSouth Carolina Department of Health and Human Services, Official page. accessed
    “If you apply through Healthcare.gov and are eligible for Medicaid, they will automatically send us your application.”
  14. SC ThriveSC Thrive, Organization. accessed
  15. Consumers (file a complaint)South Carolina Department of Insurance, Official page. accessed
  16. South Carolina state profileMovement Advancement Project, Organization. accessed
  17. Trans Health ProjectAdvocates for Trans Equality, Organization. accessed
  18. Find a Health CenterHealth Resources and Services Administration, Official page. accessed