A former state chair of the American College of Obstetricians and Gynecologists (ACOG) went public this month with her story of how the professional organization forced her to resign rather than listen to her warnings about the weak evidence for gender transition procedures. “Rather than hear my concerns and take them seriously, my national medical association chose to silence me,” wrote Dr. Karla Solheim. “They chose to be complicit in a campaign to promote ideology in medicine over evidence-backed science.”

In March, ACOG Vice President Rachel Pittman hauled Solheim into a meeting and gave her a choice: “resign from my position as chair [of ACOG’s Iowa chapter], or stop publicly criticizing ACOG’s endorsement of the World Professional Association for Transgender Health’s [WPATH] guidelines for transgender medical care.”

“The choice was easy,” Solheim said. She resigned, “because I did not intend to silence myself on an issue about which I care so much, and one that impacts so many vulnerable patients deserving of the best, evidence-based medical care.”

Solheim’s case was not the classic cancellation of Christian conservatives, but rather the Left eating another one of their own. “I’m a board-certified obstetrician, a lesbian, a mother, a lifelong Democrat,” Solheim described herself in an August 5 piece in The Free Press. “After enrolling at the University of California, I attended the University of Iowa for my medical residency, where I met my former wife; we had three kids together.”

In fact, Solheim’s lesbian identity put her in the position to question transgender medicine. In 2019, Solheim began working at UnityPoint LGBTQ+ clinic in Waterloo, Iowa several times a month and continued to take referrals once the clinic no longer fit her schedule.

“I was surprised to find that my first patient at the clinic was a biological woman who identified as a man. Even more surprising was that my second patient was too, as was my third, and nearly every patient on my schedule,” Solheim reflected. “The clinic, I learned quickly, didn’t predominantly serve the needs of lesbian or gay patients. It was, by and large, a gender clinic, there to provide medical pathways toward transition for those with gender dysphoria, including hormone replacement therapy and surgery.”

At first, Solheim performed gender transition surgeries, including hysterectomies, at the clinic without raising questions. In her mind, hysterectomies were advisable for patients taking testosterone or who didn’t want regular periods to intrude upon their attempt to live as males.

However, “in 2023, a patient came to my office seeking a hysterectomy and made me rethink everything,” Solheim wrote. “She was in her early 20s and perfectly healthy, but she did not intend to undergo a full medical transition. … I couldn’t understand how her request was any different than asking for an elective hysterectomy — a surgery that has no medical justification, and against which ACOG strictly recommends.”

“I began to reflect on this patient, and all the other patients who had come through my door asking for me to remove their uteri,” she continued. “Why was it that for a healthy young person it would be nearly impossible to get their uterus removed without an underlying medical issue, but if one were simply to identify as a man with no other plans to transition — or even just say they are nonbinary — the surgery is freely available?”

When Solheim raised these questions in a Facebook community of OB-GYNs, she encountered plenty of ridicule but few answers. “One group of respondents was highly credentialed doctors at some of the best academic institutions in the country telling me the procedure was ‘medically necessary,’ that ACOG, guided by WPATH’s guidelines, explicitly recommended it. And the second was a group of doctors who called me names like ‘ignorant’ and ‘transphobe’ for even questioning whether to perform the procedure in the first place,” she recalled. “But nobody could provide a strong, evidence-based argument as to why this procedure would help my patient get better, so I declined to perform it.”

Solheim feared telling the patient the reason why she declined to perform the surgery. “I was scared she would go into the community and tell her friends, and that I’d be labeled a ‘transphobic doctor’ and my practice would be at risk. I had seen that happen to plenty of highly regarded physicians before me.”

At this point, Solheim encountered a detransitioner, who catalyzed the shift in her thinking. “Shortly after, a detransitioner, a woman who had sought testosterone treatment to transition to male but later stopped taking it and resumed identifying as a woman, came into my office,” she narrated. “I had been told for years that detransitioning was so rare, so unlikely, that I was shocked to find someone in my small community going through it.”

This point echoes the experience of Glenna Goldis, a lesbian lawyer who was fired from the New York Attorney General’s Office for questioning the validity of transgender medical procedures. Goldis was alerted to the harms by hearing a detransitioner on a podcast. Evidently, the first-person testimony of detransitioners is a compelling way to prompt at least some far-left practitioners to rethink transgender medicine.

After this, Solheim “began to dig more deeply into the literature on transgender medical science,” expecting to find “a great body of research supporting these invasive measures.” Instead, she “couldn’t find a single good long-term, longitudinal study on the health outcomes of transgender patients who underwent treatments including hormone replacement therapy and surgery. Then I started reading books like Hannah Barnes’s ‘Time to Think,’ an investigation into what went wrong at the U.K.’s Tavistock Gender Service for Children, which shut down in 2022 after independent inspectors found it provided ‘inadequate’ care.”

“In July 2025, I tuned in to a United States Federal Trade Commission hearing that laid out a strong case that leaders within WPATH unethically manipulated their data or put pressure on researchers to produce outcomes that supported their preexisting guidelines,” Solheim continued. “I was floored to discover the research basis [for] gender medicine both for adolescents and adults was not just poor; it was fraudulent. I couldn’t understand how my medical association, let alone others in my field, could endorse it.”

This is another touchpoint with Goldis’s story. In June 2025, Goldis spoke at a Federal Trade Commission (FTC) workshop on “The Dangers of ‘Gender-Affirming Care’ for Minors.” Goldis was later hired by the FTC to investigate pediatric gender medicine as consumer fraud, after she was fired by the New York attorney general for wanting to do just that.

In December 2025, Solheim “authored an essay on my blog titled ‘Physicians Must Demand Answers from WPATH,’” which proved to be the beginning of the end. “I didn’t expect ACOG to completely disregard all of the concerns I had raised,” she said.

On February 4, 2026, “the newly appointed [ACOG] Vice President Rachel Pittman sent me an email stating my article ‘raises concerns’ because of my ‘public expression of dissatisfaction with ACOG’s inclusion of WPATH in its clinical guidance.’”

That led to a March 10 meeting, in which Pittman told Solheim to either give up her criticism of WPATH or resign. The meeting lasted only 20 minutes, and Pittman warned Solheim ahead of time that the meeting would not feature “a full discussion on the issue.”

“What made my dismissal all the more ironic was that the very day I was ousted, ACOG awarded the Iowa section the State Legislative Advocacy Award for my work to recruit and retain OB-GYNs in the state,” Solheim explained. “A week earlier, ACOG recognized me with a service award and asked me to give a presentation in Washington, D.C., about my work in Iowa to a national audience of OB-GYNs.”

In other words, Solheim was not only a member of ACOG in good standing. She was an exemplary member whose leadership earned her recognition. But when she chose to challenge WPATH, she immediately became dispensable.

“Whenever WPATH’s proponents are asked to defend their guidelines, they don’t cite the weak scientific evidence. Their strongest argument is always that all major medical associations in the United States have adopted them,” Solheim summarized. “That’s hard to argue with. And it was true until this past February, when the American Society of Plastic Surgeons became the first major medical association to no longer endorse medicalization of minors dealing with gender dysphoria.”

“I always thought once the leaders of our medical associations learned the truth, they would seek to change our guidance. But I continue to be disappointed,” she added. “The reality is that these medical associations have now become overrun by a small, loud group of activists. The leaders who we expect to guide us and hold us to the highest standards have succumbed to them out of cowardice, or even ignorance, to what is best for our patients.

Mainstream medical organizations are “now more interested in silencing critics than they are in standing up for what is best for our patients,” Solheim concluded. “I know this because it’s exactly what I witnessed at ACOG.”