In November 2008, Aalto told the media that she was a trans woman and was having a sex reassignment operation. This caused a great controversy in the Church. The bishop of Mikkeli, Voitto Huotari, commented that there is no juridical obstacle for Aalto continuing as a vicar, but that there will be problems.
In 2009 almost 600 members left the Imatra parish. In November 2009 Aalto returned to the job of vicar after spending a year on leave. In March 2010, she requested to be allowed to resign.