The toughest call Lauren Holtkamp-Sterling made as an NBA referee was the last one she made in her career.

That is, the one where she decided to retire.

Holtkamp-Sterling, who was just the third female full-time official in NBA history when she was promoted to the staff in 2014, has stepped away from on-court work because of medical reasons. She dealt with knee issues — including three ACL tears, one of them as an NBA ref — for years, was limited to 15 games last season and finally decided that her long-term health was the priority.

“My medical retirement is all about my knees,” Holtkamp-Sterling said Thursday. “It was really sad to me to bump up against physical limitations, truly. And I think it can be really tempting to sort of live in a space where you think everything is solvable and fixable. But truly, my knees just had reached the point where the miles on my joints, I couldn’t roll back the odometer on them."

Before Holtkamp-Sterling arrived in the NBA, Dee Kantner and Violet Palmer were only two women who had officiated games in league history. There are now seven more women on the full-time referee roster: Danielle Scott, Natalie Sago, Jenna Schroeder, Dannica Mosher, Ashley Moyer-Gleich, Sha'Rae Mitchell and Simone Jelks. That list is expected to grow in the coming years.

Holtkamp-Sterling wasn't the first woman through the door — but she opened it a bit wider for others to follow.

“In some ways it feels a bit like a fever dream where you look back and you go, ‘What incredibly good fortune to be part of the work that I believe was going to happen anyway,’" Holtkamp-Sterling said. "The NBA's commitment to forward progress, to social justice, to moving sport forward in so many important and nuanced ways ... that movement started well before me and is going to just continue way beyond.”

Monty McCutchen, the NBA's vice president overseeing referees, said that Holtkamp-Sterling “was an excellent referee and was well on her way to an arc that we would all have been proud of."

“Lauren was not the first woman to work here, but she most certainly contributed to breaking down beliefs and barriers that allowed more people to see themselves in the light of, ‘I, too, can do this,’" McCutchen said. "And not only did she do it, but she did it with excellence and with a sense of grace and dignity.

“It's hard to break barriers down — any barriers,” he added. "When you are on the forefront of breaking down barriers, that comes with a taxing nature to it. And Lauren always handled that extra burden very well. History can’t look back on Lauren in any way other than an amazing contributor to the success of NBA officiating.”

Holtkamp-Sterling was the first mother to officiate a game in NBA history; she and her husband, NBA referee Jonathan Sterling, became parents in 2019 and the new mom was back on the court for the first time later that same year.

And her rise to the NBA level, in some ways, was meteoric. Holtkamp-Sterling was part of the league's full-time staff 10 years after picking up a whistle for the first time — for a middle school game.

She's moving into a new career now: Holtkamp-Sterling plans to become a mental health professional.

“I certainly am going to be drawing on my 16-plus years through the D League and the WNBA and the NBA and just my experiences of really growing up through those leagues," she said. "I’m really excited about this next chapter.”

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