Trans Resource Navigator

Gender-affirming care in South Dakota

Care for adults
Allowed
Care for people under 18
Banned
South Dakota Medicaid pays for hormones
Unclear
South Dakota Medicaid pays for surgery
Not covered
Private plans must cover care
No state rule

Adults can get hormone therapy and surgery in South Dakota, but South Dakota Medicaid excludes "elective gender transition procedures" and state law does not stop private plans from excluding care. For anyone under 18, puberty blockers, hormones, and surgery for gender transition are banned (HB 1080, since July 1, 2023). There is 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. Health centers near you
  3. Hormones by telehealth
  4. Clinics, programs, and funds
  5. Paying for care
  6. Rules for adults
  7. Laws and court cases
  8. Sources

If you are under 18, or a parent

HB 1080 (2023), codified at SDCL 34-24-33 to 34-24-38 and in effect since July 1, 2023, bans health care professionals from giving anyone under 18, for gender transition:

  • puberty blockers;
  • testosterone, estrogen, or progesterone above normal levels for the minor's age and birth sex;
  • sterilizing surgery, genital surgery, or removal of healthy body parts.

Exceptions: intersex conditions (disorders of sex development) and treating complications caused by prohibited care. Minors already on blockers or hormones before July 1, 2023 had to be tapered off by December 31, 2023.

Penalties: the provider's licensing board must revoke the license. A person harmed can sue until age 25 or within three years of discovering the harm.

No court has blocked the law. South Dakota has no shield law. The Transformation Project's SD Trans Resilience Fund helps families with travel costs for care in other states (not medical bills). Mental health care, including counseling about gender, is not banned.

[2][3][4][5][6][7][1][16]

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.

  • 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

Paying for care

Medicaid (South Dakota Medicaid)[8][9][11]

The South Dakota Medicaid Physician Services manual lists "elective gender transition procedures" among services that are not covered. It does not say whether hormone prescriptions are covered; ask your provider to check before you start, and appeal any denial. Low-income adults may qualify for Medicaid; apply through the Department of Social Services.

Apply for coverage

Private insurance[10][11]

South Dakota has no law barring health plans from excluding gender-affirming care. Read your plan's exclusions list. If a claim for a covered benefit is denied, you can file a complaint with the Division of Insurance; self-funded employer plans are regulated federally.

File an insurance complaint

The rules in detail

Rules for adultsNo South Dakota law restricts gender-affirming care for adults 18 and older.

No South Dakota law restricts gender-affirming care for adults 18 and older. The barriers are cost and access: Medicaid excludes "elective gender transition procedures," and few clinics outside Sioux Falls and Rapid City advertise trans care.

If you have little money, in rough order of what to try:

  1. Planned Parenthood North Central States, Sioux Falls lists gender-affirming care, in person or by telehealth anywhere in the state, and accepts Medicaid and most insurance.
  2. Telehealth: Plume serves South Dakota. Point of Pride's HRT Access Fund and GenderBands can help with costs.
  3. Community health centers (FQHCs) such as Falls Community Health in Sioux Falls charge on a sliding scale; ask whether a provider there prescribes hormones.
  4. The Transformation Project keeps a statewide referral list of affirming medical and mental health providers.
[12][8][15][13]
Laws and court cases1 law

Sources

20 sources. Numbers in the text, like [1], point here.Show all
  1. HB 1080 (2023), An Act to prohibit certain medical and surgical interventions on minor patientsSouth Dakota Legislature, Law. accessed
  2. SDCL 34-24-33, Prohibited medical interventions, definitionsSouth Dakota Legislature, Law. accessed
    “"Minor," any person under the age of eighteen”
  3. SDCL 34-24-34, Prohibited medical interventionsSouth Dakota Legislature, Law. accessed
    “Prescribe or administer any drug to delay or stop normal puberty”
  4. SDCL 34-24-35, ExceptionsSouth Dakota Legislature, Law. accessed
  5. SDCL 34-24-36, License revocationSouth Dakota Legislature, Law. accessed
    “the board must revoke any professional or occupational license or certificate held by the healthcare professional”
  6. SDCL 34-24-37, Civil action, time limitsSouth Dakota Legislature, Law. accessed
  7. SDCL 34-24-38, Transition period ending December 31, 2023South Dakota Legislature, Law. accessed
  8. South Dakota Medicaid Billing and Policy Manual, Physician Services (updated June 2026)South Dakota Department of Social Services, Official page. accessed
    “Elective gender transition procedures.”
  9. Medical Assistance eligibilitySouth Dakota Department of Social Services, Official page. accessed
  10. Division of Insurance Complaint ProcessSouth Dakota Department of Labor and Regulation, Official page. accessed
  11. South Dakota equality profileMovement Advancement Project, Organization. accessed
  12. Sioux Falls Health CenterPlanned Parenthood North Central States, Organization. accessed
    “Gender-Affirming Care”
  13. Falls Community HealthCity of Sioux Falls, Official page. accessed
  14. HIV/STI prevention (Protect Your Parts)City of Sioux Falls, Official page. accessed
  15. Get HelpThe Transformation Project, Organization. accessed
  16. SD Trans Resilience FundThe Transformation Project, Organization. accessed
    “This fund does not cover medical expenses.”
  17. Point of PrideOrganization. accessed
  18. GenderBandsOrganization. accessed
  19. Trans Health ProjectAdvocates for Trans Equality, Organization. accessed
  20. Find a Health CenterHealth Resources and Services Administration, Official page. accessed