A well-known Florida surgeon who specializes in transgender health care has resigned from his position at the University of Miami amid an uproar over pictures he posted on Instagram that showed surgical procedures and patients’ genitals alongside captions and hashtags that mocked transgender people and Asians.
The surgeon, Dr. Christopher Salgado, 50, worked at the L.G.B.T.Q. Center for Wellness, Gender and Sexual Health at the University of Miami Health System until last month. Interspersed with photos of himself smiling with friends and colleagues, he posted images and text on his Instagram account, @sexsurgeon, that many people found disturbing. He deleted the account last month.
One post showed a CT scan of a patient with a sex toy in his rectum next to a photograph of a surgeon holding the toy after it had been retrieved, while the patient lay on a nearby table with his legs in the air. Another post showed human tissue molded into the shape of a heart alongside the message, “There are many ways to show your LOVE.” At least one other post had hashtags mocking Asian men’s genitals.
In an emotional interview with The New York Times on Wednesday, Dr. Salgado defended the posts. But he said many of them had been misunderstood and he claimed not to have written many of the hashtags, which he said he suspected were the work of hackers. He said he regretted joining Instagram a few months ago at the urging of a friend.
“It was a bad decision to even open an Instagram account, looking at it now,” he said. “The purpose really was to be educational with it, but it went awry.”
Dr. Salgado said he deleted his account on Feb. 16, after complaints from a user who he suspects tipped off L.G.B.T. news outlets to his posts. That user also complained to the university, he said, and he was told that he would be suspended while an investigation was conducted.
He thought administrators had prejudged him, he said, so he resigned via email.
Last week, the online magazine Trans Advocate published the first article about the doctor’s social media activity. The magazine reported that his Instagram posts had been shared in several Facebook groups devoted to transgender medical care and that people quickly became alarmed by the graphic images and mocking captions.
“One expects a certain level of professionalism and decorum from medical professionals, and it’s hard to imagine what Salgado was thinking when he made these posts,” wrote Noah Adams, the author of the Trans Advocate piece.
A petition demanding action from the American College of Surgeons and the Florida Board of Medicine was soon posted online. A spokesman for the Florida Department of Health said the agency could not comment on a practitioner until 10 days after probable cause of wrongdoing was found. The American College of Surgeons said that it was not a national governing body for American surgeons and that many surgeons, including Dr. Salgado, are not members.
“Beyond Dr. Salgado’s blatant disrespect for trans people, his public vulgarity, lack of professionalism, and questionable ethics around patient privacy must be immediately addressed,” the petitioners wrote.
Dr. Salgado defended himself on Wednesday, saying that he had “devoted a lot of time to this patient population.” He said he could now see that some of his posts were in poor taste, but emphasized that his goal had been to raise awareness.
“Yeah, these are patients’ genitals, but it was teaching,” he said. “It was basically educational: This is how we do this transformation. I felt like it really was educational.”
The doctor said he did not write some of the hashtags, including some that were sexually graphic. He said that he suspected hackers’ involvement and that he had received an email (which he ignored and then deleted) from Instagram last month warning that someone had logged into his account from Turkey.
He added that some of the posts had been misunderstood. Some pictures, he said, were uncredited images from other sources that had been mistakenly attributed to him, including the picture of the sex toy. Others, like the heart-shaped human tissue, had been misconstrued by nonmedical audiences, he said.
“That post was a dermal thigh graft, but they said it was a penis,” he said, referring to other news articles about his posts. “I probably put the hashtag penis on it, but it wasn’t a penis. It was a specimen.”
But he acknowledged that he did write some of the inflammatory hashtags, including several about Asian men beneath an image explaining the medical condition of micropenis.
“I put that there were options for fixing micropenis, then I put the hashtag Asian penis,” he said. “That was probably in poor taste, but it was mine.”
The doctor said he thought his posts did not violate anyone’s privacy because patients at the university hospital give their consent for non-identifying pictures to be used in publications, news media and conference presentations. A university spokeswoman did not respond to a message on Wednesday asking to confirm its policy.
“I don’t think any of that even applies because there are no patient identifiers, so no one is going to come and say, ‘Oh that is my neo-clitoris,’” Dr. Salgado said, using the term for a surgically constructed clitoris.
He added: “I was using no patient identifiers and no hospital identifiers, so you can’t tell who the patients are, what the hospitals are. You can’t even tell who is who.”
He thought the hashtags were his downfall, he said.
“The hashtags were what people found the most offensive,” Dr. Salgado said. “It doesn’t seem like it is related to the content that much because it was meant to be educational. But once the hashtags were added it became different.”
Lisa Worley, a spokeswoman for the University of Miami Health System, confirmed in a statement that the university no longer employed Dr. Salgado. She focused on the language used on his Instagram page and did not mention any potential privacy concerns.
“The University of Miami is committed to promoting and supporting diversity in its students, faculty, and staff and finds any transphobic comments unacceptable,” she said. “As health care providers, we continue to have a team of experts dedicated to delivering the full continuum of care for gender reassignment patients.”