U.S. ACOG Section Chair Resigns After Criticism of WPATH Guidelines

An American gynecologist who performed gender-affirming surgeries for years was forced to make a choice in March 2026: remain silent about her criticism of the WPATH guidelines, or give up her position on the board. She chose the latter—and has since told the American press why.

From Practitioner to Critic

Dr. Karla Solheim is a board-certified obstetrician-gynecologist, self-described lesbian Democrat, and mother. She served as chair of the Iowa section of the American College of Obstetricians and Gynecologists (ACOG) for approximately a year and a half, 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 (World Professional Association for Transgender Health). What the WPATH messages leaked in 2024 revealed about clinicians’ doubts is described on transtijd.nl. Her conclusion was unequivocal: in her view, the research underpinning the guidelines was not merely weak but outright fraudulent. According to her, there is no robust evidence for the long-term benefits of these treatments—while the irreversible nature of the procedures is beyond dispute.

An Ultimatum from Her Own Association

In December 2025, Solheim put her objections 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 Chair Rachel Pittman informed her by email that the piece had "raised concerns"—particularly because Solheim had publicly expressed her dissatisfaction with the way ACOG had incorporated the WPATH guidelines into its own clinical guidance.

On March 10, 2026, a meeting followed in which Pittman presented her with 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"—an article that caused considerable uproar in American healthcare circles.

What Her Case Reveals More Broadly

Solheim is not the first doctor to clash with her 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 performed the procedures she now criticizes. That is precisely why, she argues, her message deserves a hearing: when authoritative medical bodies 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 matter.

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. Why the evidence underpinning the WPATH guideline is considered weak is explained on wpath.nl. For the professional associations themselves—ACOG foremost among them—the question Solheim raised remains unanswered: if the criticism is unfounded, why not refute it on the merits instead of showing the critic the door?