One gender care option ends, patients face hurdles

SIOUX FALLS, S.D. (KELO) – When Jack Fonder heard that gender-affirming care ended at Avera Health, he acted fast to connect transgender patients to the care they needed.
'When you talk about losing access to health care, that does affect a lot of people,' said Fonder, outreach facilitator for the Transformation Project.
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According to the World Health Organization (WHO), gender-affirming care is defined as healthcare that supports a patient's gender identity, in treatments such as medical (hormonal replacement or surgery), behavioral, psychological and social.
Over the past month, Fonder learned through many voices at the Transformation Project that transgender patients received letters from their Avera physicians stating an end to gender-affirming care.
'Within the Avera health system, we have some really great allies, doctors, nurses that are 100% OK with serving all of the population of Sioux Falls and surrounding areas,' said Fonder. 'What it looks like now is, unfortunately, individuals do have to find a different healthcare provider.'
In a statement provided to KELOLAND News, Avera Health said the following:
Avera treats all people who come to us with dignity and respect. As a Catholic healthcare provider, there are certain interventions we do not provide. In such situations, patients have the opportunity to seek a provider that would offer those interventions.
Avera Health
In 2023, South Dakota passed a law banning gender-affirming care for anyone under the age of 18. The U.S. Supreme Court is also considering a case regarding gender-affirming medical treatments for transgender minors.
'I'm a trans person myself, too, so I know how important this care is, and I know how hard it is when you have to just constantly worry about am I going to have access to the care that I need to survive every day?' Fonder said.
As Fonder explained, finding new health care options as a transgender person can be difficult.
A transgender or gender diverse person seeking gender-affirming care must present a letter from a therapist to access care from a physician, Fonder explained. This could be a months-long process for individuals, as scheduling appointments for either a therapist or doctor can book out fast.
'That's not good because when you are on hormone replacement therapy, you need your prescriptions to be filled in a timely manner,' said Fonder. 'It's very important that you stay on those things on a schedule.'
On one hand, there's receiving timely care, and on the other hand, there's making sure insurance covers that care, Fonder added. He said transgender individuals with Avera-only insurance will face a new struggle.
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'They're going to have to start paying out of pocket to go to other places to get to have access to the care that they need,' said Fonder.
Fonder encourages anyone in the community to reach out to the Transformation Project if they've lost access to healthcare through Avera Health. Fonder said the Transformation Project can help connect transgender patients to new doctors and therapists, or offer support to anyone feeling overwhelmed by the entire process.
'It's terrible, but it was good that we knew and we were able to kind of inform some of our clients and our population of people that we work with so they could start taking steps to move forward with what they needed to do in that situation,' said Fonder.
The Transformation Project is an organization supports transgender individuals and their families, while educating state communities about gender identity and expression, according to its website.
According to its website, Avera Health is a non-profit, ministry-driven health system in the upper Midwest that offers over 60 medical specialties.
Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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