American ACOG Section Chair Resigns After Criticizing WPATH Guidelines

An American obstetrician-gynecologist who performed gender-affirming surgeries for years faced a choice in March 2026: remain silent about her criticism of WPATH’s guidelines or give up her position on the board. She chose the latter—and has since been telling the American press why.

From Practitioner to Critic

Dr. Karla Solheim is a board-certified obstetrician-gynecologist, self-described lesbian Democrat, and mother. For about a year and a half, she chaired the Iowa section of the American College of Obstetricians and Gynecologists (ACOG), where she focused primarily on improving access to women’s healthcare in rural areas. Until 2023, she performed gender-affirming hysterectomies herself—fully confident, as she later put it, that the guidelines supporting these procedures were based on sound evidence.

That confidence began to erode when she started examining the underlying literature and internal documents of WPATH (the World Professional Association for Transgender Health). Her conclusion was stark: in her view, the research underpinning the guidelines was not merely weak but outright fraudulent. According to her, there is no robust evidence supporting the long-term benefits of these treatments—while the irreversibility of the procedures is beyond dispute.

An Ultimatum from Her Own Association

In December 2025, Solheim put her concerns in writing in an essay titled "Physicians Must Demand Answers from WPATH," published on her own Substack. ACOG’s response was not long in coming. On February 4, 2026, vice president Rachel Pittman informed her by email that the piece had "raised concerns"—particularly because Solheim had publicly expressed her displeasure with the way ACOG had incorporated WPATH’s guidelines into its own clinical guidance.

On March 10, 2026, a meeting followed in which Pittman gave her a choice: stop criticizing WPATH or resign as section chair. Solheim chose the latter. She subsequently made her story public in an essay for The Free Press, titled "My Medical Association Silenced My Views on Gender Treatment"—a piece that caused considerable turmoil in American healthcare circles.

What Her Case Reveals More Broadly

Solheim is not the first doctor to clash with her own professional association after criticizing WPATH, but her profile makes it difficult to dismiss the case as politically motivated: she explicitly describes herself as a Democrat and a lesbian, and for years she personally performed the procedures she now criticizes. That is precisely why, she argues, her message deserves a hearing: when authoritative medical institutions categorically dismiss legitimate concerns instead of addressing them on their merits, they ultimately undermine trust in the profession as a whole—not just in this particular area.

Her case joins a series of similar reports from American doctors and nurses who have come forward in recent years to criticize the scientific basis of gender-affirming care for both minors and adults. For the professional associations themselves—with ACOG at the forefront—the question Solheim raised remains unanswered: if the criticism is unfounded, why not refute it on its merits instead of showing the critic the door?