Talk:Metoidioplasty

Reconsider appropriateness of images?

While the images are relevant to the topic at hand, they are extremely graphic and are likely to be unpleasant and unwanted by most people viewing the page. Given that this page has to do with an important social issue, namely transgender topics, it is preferable that it be accessible to as many people as possible. While the images are treated in an encyclopedic fashion, I think it is reasonable to classify them as gratuitous, and they fail to follow the recommended policy of least astonishment (a preferable image would be a non-photographic diagram of the procedure). Additionally, the images do not appear to be included for the sake of "increasing readers' understanding of the article's subject matter", and could also be considered to be giving "an undue or distorted idea" of metoidioplasty, given their graphic nature. Based on this, I've removed the images.

Additionally, the user who posted the images, M213m213, appears to have placed similarly graphic images on other pages, namely Penile injury and Sex reassignment surgery (female-to-male), which I've also removed for the same reasons stated above.

EnigmaofAzoth (talk) 15:43, 9 July 2020 (UTC)

EnigmaofAzoth, regarding this, this and this? See WP:Not censored and WP:Offensive material. We actually do show images of surgeries, or the results of those surgeries, including surgeries on the sex organs or the breasts; see the Phalloplasty and Breast augmentation articles. By you stating that "the images do not appear to be included for the sake of 'increasing readers' understanding of the article's subject matter", it appears you are aware of what WP:Offensive material states. But I'm sure people would disagree with you that showing images of the surgeries or the results of those surgeries does not increase readers' understanding of the article's subject; they would feel that it makes the articles less informative. I don't have a strong opinion on this matter, but I can see how not having such images in the articles makes the articles less informative.

For wider input, I'll alert WP:Med to this discussion. Flyer22 Frozen (talk) 00:50, 10 July 2020 (UTC)

Hi; thanks for posting to WP:Med. I am in favor of restoring the images to this page and the others. They are not meaningfully more graphic than the notorious lasagna that is infective endocarditis, nor are they grossly (pun intended) outside the norm of what I would expect to find in a medical textbook.―Biochemistry🙴❤ 02:12, 10 July 2020 (UTC)

Flyer22 Frozen, you're correct that I did try to familiarize myself with the relevant policies before making these edits, though it is possible that I misunderstood, or took a uncommonly hard stance on the topic. Given that similar images are included in medical textbooks as stated by Biochemistry&Love, I do think my original critique of the images as insufficiently educational was misplaced, or at least that the case is ambiguous enough to allow to stand. However, I will maintain that they seem to fall somewhat outside of the policy of least astonishment, and I'd point to the precedent set elsewhere in sex reassignment surgery-related pages, which (from my brief survey) seem to skew more towards depicting results rather than in-progress surgeries (see Phalloplasty for an example). While I don't have a broad-scale issue with graphic depictions elsewhere on Wikipedia, I do think this subject specifically deserves somewhat deeper consideration due to being tied to transgender topics, and thus potentially a source of information for trans youth and older trans people who might be considering the procedure, who might be scared off by the images. That's why I referenced the policy on images giving "undue or distorted" ideas of a subject before.

A better solution in my mind would be to use a more abstracted diagram style of image of the procedure itself, with a photograph of the end result. I'm a very new user, having made an account specifically to address this topic, so it is quite possible that I jumped the gun a bit here, and if the general trend is in favor of reinstating the images, I will defer to users with more experience on the topic.

EnigmaofAzoth (talk) 03:04, 10 July 2020 (UTC)

@EnigmaofAzoth: While I—and undoubtedly those commenting below—am sensitive to the concern that we may "scare off" readers (especially those in a vulnerable population), if someone is traveling to a page that is about surgery, then one may reasonably expect to find surgical images there. It may not be pleasant, but people are made out of meat. Surgery involves, well, surgery.―Biochemistry🙴❤ 20:35, 10 July 2020 (UTC)

EnigmaofAzoth, I understand your concern. You can contact WP:LGBT about weighing in on this for their opinions. Per WP:APPNOTE, keep the note there neutral if you do. As for WP:Principle of least astonishment? While "principle of least astonishment" is mentioned at WP:Manual of Style/Images#Offensive images and WP:Offensive material, it's not a policy or guideline. The WP:Policies and guidelines page addresses what policies, guidelines, essays and other pages mean in the context of Wikipedia protocol. Flyer22 Frozen (talk) 23:16, 10 July 2020 (UTC)

• As a non-expert on the topic, I think the images do significantly improve my understanding of the procedure, assuming that they are accurately representative of the procedure. Diagrams would also probably be informative, but they should probably be in addition to actual photographs, as the information in a photograph and a diagram are not entirely the same. I would have no objection to replacing photos with better photos, but until that is done, I recommend restoring the existing photos as appropriate, valid and relevant information and the best we have available. · · · Peter Southwood ^(talk): 09:42, 10 July 2020 (UTC)
• Same opinion for the related removals at Penile injury and Sex reassignment surgery (female-to-male). · · · Peter Southwood ^(talk): 09:50, 10 July 2020 (UTC)
• Please restore all the images. This is an encyclopedia. We cannot start removing valuable content and information from the encyclopedia just in case some of the readers might feel put off. We would be doing the readership as a whole a disservice. Dr. Vogel (talk) 19:56, 10 July 2020 (UTC)
  • The images have all been restored pending the outcome of this discussion. · · · Peter Southwood ^(talk): 10:14, 11 July 2020 (UTC)

The surgical images have clear encyclopedic value and must be retained, but I think the article is unbalanced without also including a healed “after” photo showing the normal day to day appearance of the result. I think most readers come to this article to find out what the heck metoidio even is, possibly even to find out if it *is* a surgical procedure (since not all trans milestones are surgical), and those readers will best learn their desired information from the lead and a normal “after” photo. The current photos don’t actually answer their question, of what outcome is achieved. For the readers who continue on to learn more about the “how” rather than the “what”, the surgical images will be useful then. Of course, *acquiring* a suitable “after” photo might be difficult, but if one could be found I think it would be the most appropriate first image. ~ oulfis 🌸(talk) 03:26, 22 July 2020 (UTC)

Yes, an "after" photograph would be beneficial to the article. Flyer22 Frozen (talk) 04:28, 22 July 2020 (UTC)

I agree with many of the sentiments expressed above. In particular, the image of the completed result of the procedure was given insufficient context (especially time post-operation). This isn't mentioned in the article from which the current images are sourced, so I've emailed the authors to clarify (I appreciate that inclusion of the resulting information is technically WP:OR, however I think would be clearly appropriate in this case). Additionally, it would be extremely valuable to have an equivalently healed mage to File:Penis_post-operative_of_transgender_phalloplasty.jpg. Unsurprisingly, such images are extremely hard to come by, so I have also contacted the authors to ask if they have access (with informed consent) to appropriate examples. These would go a long way to providing the necessary balance to avoid over-emphasising the surgical aspect, and avoid misleading on the results of the procedure. Finally, my understanding is that there are a few alternative methods, so a summary illustration of them would be ideal, but this area of medicine produces almost no open access literature yet, so may likely require contacting some more experts in the field. T.Shafee(Evo&Evo)^talk 11:23, 16 October 2020 (UTC)

I've also contacted a couple of members of the FtM community to make sure that we have some additional community input as well as the medical input. T.Shafee(Evo&Evo)^talk 23:54, 18 October 2020 (UTC)

Finally, by chance, a 2 yr post-op resulting image has been published in an OA journal. Sadly the other people I contacted above initially responded but never came through, so I'll use the image from the Bordas et al paper. T.Shafee(Evo&Evo)^talk 08:05, 20 November 2021 (UTC)