Medical care for minorsBan▾
MedicaidFederal funding ended (minors)▾
Medicaid doesn't pay for sex-change procedures at any age. A federal CMS rule ends federal Medicaid and CHIP money for puberty blockers, cross-sex hormones and surgery for minors.
42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)
State employeesNo explicit policy▾
State-employee plans have no explicit rule on sex-change procedures.
South Dakota state-employee health plan document (sd.gov)
SportsSex-based▾
Girls' sports are protected: state law keeps males out of girls' and women's teams (K-12 and higher education).
SB46
FacilitiesSex-based (schools + government buildings)▾
Bathrooms and changing rooms in K-12 schools, and government buildings are separated by sex, so males stay out of women's and girls' spaces.
HB1259 (2025).
Pronouns and parent noticeNo state law▾
No state law requires schools to tell parents if their child socially transitions at school.
No state law identified (statute review, Oct 2026)
CurriculumNo state law▾
No state law on gender-identity lessons; local school boards decide.
No state law identified (statute review, Oct 2026)
Sex definitionDefined by biology▾
ID markersBirth-certificate sex cannot be▾
Birth-certificate sex cannot be changed; licence policy unclear.
South Dakota Unified Judicial System opinion
Shield lawNone▾
No shield law.
No shield statute identified
AdultsRestricted (funding)▾
Adults: no taxpayer money for sex-change procedures (Medicaid exclusion at all ages).
SOUTH DAKOTA MEDICAID BILLING AND POLICY MANUAL (dss.sd.gov)
DetransitionNo state law▾
No special right for detransitioners to sue.
No state law identified
PrisonsCase-by-case▾
Pending billsNo active bills▾
No active bills (checked 13 Oct 2026). The 2026 regular session has adjourned (or the legislature does not meet in 2026), so 2025-26 bills are no longer moving. LegiScan search linked.
LegiScan search, checked 13 Oct 2026 (adjourned legislature)
LitigationNone identified▾
No active court case on these laws identified in this review.
Review, Oct 2026
Key datesNone upcoming▾
No upcoming effective dates or court deadlines identified.
Review, Oct 2026
Sources
- South Dakota Legislature (HB1080)
- 42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)
- Official source: dss.sd.gov
- South Dakota state-employee health plan document (sd.gov)
- SB46
- HB1259 (2025).
- HB 1184
- South Dakota Unified Judicial System opinion
- SD DOC Policy 1.4.E.13
- LegiScan search, checked 13 Oct 2026 (adjourned legislature)