A trans woman, who has chosen to remain anonymous for privacy reasons, has publicly voiced her outrage after discovering that a photograph of her was used in a widely adopted medical school textbook to illustrate a “male skeletal structure.” She described the decision as “outrageous and disrespectful,” arguing that it completely disregarded her gender identity and reduced her to a biological category she no longer identifies with. The revelation has ignited a broader conversation about consent, ethical image use, representation in academic materials, and the responsibilities of educational publishers in an era of increasing awareness around gender diversity.
The woman explained in a series of social media posts that she had previously consented to having her image used in a general anatomical context during a photoshoot several years ago, believing it would contribute to educational resources on human biology. She was shocked to learn recently—through a current medical student who recognized her photo—that the image had been repurposed in a prominent textbook chapter on skeletal anatomy.
The caption accompanying the photo reportedly labeled it as an exemplar of typical “male skeletal features,” such as broader shoulders, narrower pelvis, and more pronounced brow ridge characteristics often associated with individuals assigned male at birth.
“This isn’t just about one picture,” she wrote. “It’s about erasing who I am now. My transition, my identity, my lived experience—none of that mattered to them. They took my image and used it to reinforce a binary that I’ve worked hard to move beyond. It feels like a violation.” She emphasized that while she understands skeletal differences often persist after puberty and hormone therapy (as supported by various studies on bone microarchitecture in transgender individuals), the issue lies in the lack of transparency, updated consent, and sensitivity in how her likeness was applied.
The incident underscores ongoing challenges in how medical education handles gender and sex in instructional materials. Anatomy textbooks have historically defaulted to male bodies as the “standard” for non-reproductive structures, with female bodies primarily featured in sections on reproductive anatomy. Recent analyses of popular atlases and textbooks reveal persistent underrepresentation of women overall, let alone transgender or non-binary individuals. For instance, comprehensive reviews have shown that male depictions dominate whole-body and regional illustrations, even when no sex-specific traits are required.
Transgender bodies remain virtually invisible in most standard texts, with only isolated recent editions beginning to include them—often in limited contexts.
Advocates for greater inclusion argue that such oversights are not merely oversights but contribute to a hidden curriculum that marginalizes diverse identities. When transgender individuals appear—if at all—it is frequently in pathology-focused discussions or as exceptions rather than normalized examples of human variation. In this case, using a trans woman’s photo to exemplify “male” skeletal traits without any acknowledgment of her transition or identity amplifies feelings of invalidation. Critics point out that educational content should reflect contemporary understandings of sex, gender, and biology, especially as gender-affirming care becomes more visible and studied.
The debate extends to questions of consent and intellectual property in medical publishing. Images used in textbooks are often sourced from stock photography, medical databases, or commissioned shoots, but the original intent of the subject may not align with final usage. Ethicists argue that explicit, ongoing consent should be required when images depict identifiable individuals, particularly in sensitive contexts like gender or identity. Without it, such practices risk exploitation, even if unintentionally. In this instance, the woman claims she was never informed of the specific application or given an opportunity to withdraw permission after her transition.
Supporters of improved representation in academia have seized on the story to call for systemic changes. Organizations focused on LGBTQ+ health equity stress that inclusive materials benefit all students and future physicians by fostering cultural competence and reducing biases in clinical practice. They advocate for guidelines requiring publishers to diversify imagery, include disclaimers about biological versus affirmed gender, and prioritize trans and non-binary models where appropriate. Some suggest collaborative efforts with transgender communities to create accurate, respectful visual resources—perhaps even dedicated sections on how hormone therapy influences bone density, muscle attachment points, or other features without negating identity.
On the other side, some educators defend the use of archetypal examples in anatomy teaching, noting that skeletal sex differences remain a foundational concept in fields like forensic anthropology, orthopedics, and archaeology. They argue that distinguishing between biological sex markers (largely fixed post-puberty) and gender identity is necessary for scientific precision. However, even within this perspective, many acknowledge that labeling a specific person’s image as “male” when that individual identifies otherwise crosses into personal territory rather than pure science.
As of now, the textbook publisher has not released an official statement addressing the allegations, and details about the specific edition or title remain unverified beyond the woman’s account and circulating screenshots. Medical students and faculty who have commented anonymously suggest the book in question is one of several standard references used in U.S. and international curricula. Calls for a recall or erratum have begun circulating online, alongside petitions urging greater transparency in image sourcing.
This controversy arrives amid broader shifts in medical education toward inclusivity. Recent editions of some major anatomy texts have started incorporating more diverse representations, including occasional depictions of transgender individuals in updated chapters. Yet progress remains uneven, and cases like this highlight how far the field has to go in balancing scientific accuracy with respect for individual dignity.
The trans woman at the center of the story hopes her experience prompts meaningful reform. “I’m not asking to rewrite biology,” she stated. “I’m asking to be seen as human, not just a teaching tool. If my image is going to be used, let it reflect truth—my truth included.” Whether this leads to concrete changes in how publishers select and label images remains to be seen, but it has undeniably amplified demands for a more equitable, considerate approach to representing bodies in the pages that train tomorrow’s doctors.
