DSD itself is not allowed to leave a player unless it's encrypted. i.e. it has to be over HDMI.
And then you need a decoder that can handle it. The receivers and pre/pros that I know which can decode it can't apply any digital processing -- no Audyssey or other room correction can be applied, (I read somewhere that the DSD signal actually goes directly into the DACs which drive the receiver's outputs.)
Players are allowed to decode DSD and provide the resulting analog signals on their analog outputs, of course, or as standard resolution PCM. PCM can then be transmitted over HDMI or S/PDIF (optical or coax). Of course, S/PDIF is limited to two channel PCM, while HDMI would be needed for multichannel soundtracks.