A Miami surgeon known for his gender reassignment work with trans patients has lost his job after it was discovered that he’d been posting offensive, explicit images of his patients’ body parts to a secret Instagram account without their consent.

According to The Trans Advocate’s Noah Adams, Dr. Christopher Salgado of the University of Miami Health System had been operating the since-deleted Instagram account, @sexsurgeon, since at least as far back as October of last year. There, he would post pictures of surgically removed genitals, pairing them offensive captions intended to be humorous.

In one photo, posted on Valentine’s Day, Salgado rearranged a patient’s dissected, severed penis into a heart shape, tagging it “#whatthefuckisthat,” and he captioned a photo of a dildo removed from a person’s rectum with “could have been avoided if the transman had a real phalloplasty” and the hashtag “#realdicksmatter.” Salgado — who appeared on an episode of TLC’s I Am Jazz, providing a gender reassignment surgery consultation to series star Jazz Jennings — also used racist and ableist language in his captions, tagging a penile enhancement pic “#asiancock” and calling a trans patient in need of a phalloplasty implant an “implant cripple.”

Salgado’s secret Instagram account was discovered by an unnamed source and posted to a phalloplasty support group on Facebook on Feb. 17, The Trans Advocate reports. Before long, a number of emails and a 500-signature strong petition had been sent to Salgado, his bosses, and WPATH (the World Professional Association for Transgender Health) calling for accountability. The University of Miami Health System responded swiftly, ending Salgado’s employment within two days.

“The University of Miami does not comment on the detailed status of employees,” Salgado’s former employers told The Trans Advocate. “However, we can confirm that Dr. Christopher Salgado is no longer employed by the University of Miami. We continue to have a team of experts providing the full continuum of care for gender reassignment patients.”

While warranted, Salgado’s termination will likely complicate a number of trans patients scheduled surgeries. (Gender reassignment surgery and other trans-affirming procedures are generally scheduled at least a year or more in advance.) The Trans Advocate says the University of Miami plans to reassign Salgado’s patients to Dr. Ajani Nugent and that the Johns Hopkins Center for Transgender Health.

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