Talk:Toby Meltzer

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Contents 1 Discussion 2 What the article needs 3 Addressing what the article needs 4 Citations regarding surgical technique 5 Need Assistance Regarding Photo Upload

[edit] Discussion

• Please do not speedy-delete. Toby Meltzer is pretty notable and is a well known pioneer of sex-reassignment surgery. Google shows up about 2000+ hits. - Alison^✍ 23:27, 14 September 2006 (UTC)

You have to show evidence of his notability in the article: something that satisfies WP:BIO. ... discospinster _talk 00:10, 15 September 2006 (UTC)

"The person made a widely recognized contribution that is part of the enduring historical record in their specific field."

"Published authors, editors and photographers who received multiple independent reviews of or awards for their work"

From: www.tmeltzer.com/drmeltzer/

Publications in Peer-Reviewed Journals:

 · Meltzer TR and Myers MB: The effect of hyperbaric oxygen on the bursting strength and rate of vascularization of skin wounds in the rat. American Surgeon, Vol 52, 12:659-662, 1986.

 · Meltzer TR, Miyakawa T, DePoli PA, Sachs R, Faraq A, Mammen EF, Heggers JP, Robson MC: Hemostasis parameters and survival in burn patients. Surgical Forum 38:636-638, 1987.

 · Phillips LG, Robson MC, Heggers JP, Meltzer TR, Boertman JA, Manavalan K: The effect of burn care on skin bacteria and burn wound sepsis. Australian and New Zealand Burns Bulletin, Vol 1, 3:12-13, 1988.

 · Smith, Jr, DJ, Robson MC, Meltzer TR, Smith AA, McHugh TP, Heggers JP: DRG-driven change in burn wound management: A success story. Plastic and Reconstructive Surgery 82:710-712, 1988.

 · Phillips LG, Heggers JP, Robson MC, Boertman JA, Meltzer TR, Manavalan K, Smith DJ: The effect of endogenous skin bacteria on burn wound sepsis. Plastic and Reconstructive Surgery, 1989.

 · Phillips LG, Jarlsburg C, Mathoney K, Gracia W, Meltzer TR, Smith DJ, Robson MC: Meshed Biobrane: A dressing for difficult topography. The Journal of Burn Care & Rehabilitation, Vol. 11, No. 4:347-351, 1990.

 · Meltzer TR: Basal Cell Carcinoma. The Western Journal of Medicine, Vol. 158, No. 4: 403, April, 1993.  · Wheatley MJ and Meltzer TR: The Role of Vascular PedicleThrombectomy in Management of Compromised Free Tissue Transfers. The Annals of Plastic Surgery, Vol. 36, No. 4:360-4 April, 1996.

 · Wheatley MJ and Meltzer TR: The Management of Unsalvageable Free Flaps. Journal of Reconstructive Microsurgery, Vol. 12, No. 4:227-229, May, 1996.

 · Swift RW, Wheatly MJ and Meltzer TR: A Safe, Reliable Method for Skin Graft Coverage of the Radial Forearm Donor Site. Journal of Reconstructive Microsurgery, Vol. 13, No. 3:471-3, October, 1997.

 · Wheatley MJ, Meltzer TR, Cohen JI: Radial Forearm Free Flap Tracheal Reconstruction After Parastomal Tumor Resection. Plastic and Reconstructive Surgery, Vol. 101. No. 5:1342-4, April, 1998.

 · Takata, LL and Meltzer, TR: Procedures, Postoperative Care, and Potential Complications of Gender Reassignment for the Primary Care Physician. Primary Psychiatry, Vol, 7, No. 6:74-78, June, 2000.

 · Yang CY, Palmer AD, Murray KD, Meltzer TR, Cohen JI: Cricothyroid Approximation to Elevate Vocal Pitch in Male-to-Female Transsexuals: Results of Surgery. Ann Otol Rhinol Laryngol, Vol, 111 (6): 477-85, June 2002.

He's also lectured extensively on re-assignment surgery and is considered to be one of the primary surgeons for SRS, along with Marci Bowers, Gary Alter, etc. He is at least as notable as these two. - Alison^✍ 00:38, 15 September 2006 (UTC)

• This article DOES NOT meet any of the criteria for deletion. In fact deleting this article would create significant controversy. I believe that deleting this article would violate the formal policies of the Wikipedia. Its appearance in the deletion list is non-sense. Dr. Meltzer's work is medically important to vaginoplasty and metoidioplasty, as Dr. Barnard's work is medically and historically important to heart transplant surgery. Shame on whoever suggested that this article be deleted. janniejdoe 20:52, 14 September 2006.

• Toby Meltzer, MD has been insrumental in making advances in vaginoplasty surgical technique. He is an internationally known plastic and reconstructive surgeon whose work has medical and historical significance. His peer reviewed articles appear in prestigious medical journals. He is far worthy of appearance in an encyclopedia than countless psuedo celebrities whose appear in wikipedia has never been challenged. Maintaining reference to him in those resource enhances its credibility and utility. He is also referred to in several other wikipedia articles. Shame on anyone who suggests deleting this entry about him.janniejdoe 19:15, 14 September 2006.

• I have removed the erroneous "cleanup" and "advertisement" tag. Dhartung has not provided any basis or citations for inserting these erroneous tags. Dhartung should volunteer to make a grammatical or syntax edits Dhartung believes would help this article. In the mean time, I have increased its level of detail and cleaned up its language. Rather than simply inserting such tags in a drive by, trolling, manner, people ought to actually edit an article they think needs grammatical improvement. janniejdoe 17:25, 15 September 2006.

[edit] What the article needs

I have done some clean up and wiki-fying of the article. I have also added sources for comments where I could find reliable ones. The one area where I hit a major roadblock is the references to the techniques that he's pioneered. All the sources that I could find (at least on-line) are either blogs, self-published, or second/third hand sources which wouldn't be appropriate to put in the articles. I suspect what I need to find is located in some of the ASPS medical journals but unfortunately you have to pay for access to them. In regards to the AfD, if someone can fill in the gaps with sources in those key areas it will go a long way to saving this article. Agne 15:22, 17 September 2006 (UTC)

[edit] Addressing what the article needs

• I have added some links to reference information regarding Dr. Metlzer's invention of pioneering surgical technique. I have removed the stub notation now that the article has been further refined. There are thousands of wiki articles that don't live up to the present standard of this article. janniejdoe 17:37, 17 September 2006.

The sources do say that Toby uses those techniques but they don't back up the claim that he pioneered them, which is of substantial relevance. Secondly, I do think the link to the sites with photo should contain the description Graphic Photos rather then just Surgical Photos. I don't think Wikipedia should be censored but "graphic" tends to convey that more then just blood will be shown in the photo. Agne 00:46, 18 September 2006 (UTC)

Obviously I disagree with the note about the photographs. The term "graphic" tends to inappropriately stigmatize the nature of the photography. The photographas, are clinical and medical in nature. They are scientifically relevant and in no way should be associated with things like pornography or "grpahic" sexuality that somme cultures consider inappropriate for some audience. Noting that they are Surgical photos makes their content emphatically clear for anyone who might not be emotionally or psychologically mature enough to view them. There are plenty of articles on wikipedia about medical issues, with photographs, that do not include any such warnings, e.g.:

Breast_implant/Risks_and_debate

Breast_implant

If you took the time to read the entirety of the information Anne Lawrence, MD provides on Dr. Metlzer's work and techniques, you will see that his origination of his techhniques and procedures are documented there. See also the referenced article by Takta, LL and Meltzer, TR, in pubmed. I believe this article is being held to a ridiculous and unfair standard, that is not representative of the wikipedia. I believe that the microscopic treatment this article has received is evidence of bias against its subject matter, while the simple fact is clear that this surgeon is referenced repeatedly in other wikipedia articles about related surgical topics. In addition, the very nature of the subject matter should be protected a topic given the level of bigotry, discrimination, and violence including murder against people who receive these medical treatments. The very fact that a surgeon like Toby Meltzer, with such a prestigious medical background, chooses to concentrate on such service to other people, who have few if any equally qualified alternatives, is notable by itself, without need for any further citation. These surgeries are in and of themselves pioneering, and largely non-existent on any measurable scale before the 1960s. Even now, the number of frequent U.S. practitioners is few, including only Meltzer and Marci Bowers, MD (who was previously a patient of Meltzer!), on a truly regular basis. janniejdoe 19:29, 17 September 2006.

Graphic does not equate to pornography and in no way disparges the subject matter of the image. However, there is an inherent "shock factor" to images of the genitalia (more so than breast) and it is appropriate to be explictedly clear at what a reader can expect when clicking those links. I do believe the term "graphic" will be more clear then surgical alone. Maybe the best solution would be to call it "Graphic Surgical Images"? Agne 02:48, 18 September 2006 (UTC)

In regards to the sources, your comment "If you took the time to read the entirety of the information Anne Lawrence, MD provides on Dr. Metlzer's work and techniques, you will see that his origination of his techhniques and procedures are documented there." I will say that you haven't supported your point. The 3 in-line citations you give go to various points on the same photo strip of an SRS procedure. While they obviously show that Dr. Meltzer uses those techniques, in none of the captions is it noted that he pioneered them. Now if you are implying that I need to read the volume of data on Anne Lawerence's site in order to verify the claim, then you are missing a key element of WP:V and WP:CITE. The in-line citation should go directly to where the claim is being supported. If you can do that, I wholeheartedly encourage you to do so because it will improve the article a great deal. Agne 02:55, 18 September 2006 (UTC)

Once again, I disagree on all counts. It should be PATENTLY obviously to anyone reading about vaginoplasty and metoidioplasty surgery whose purpose is the creation of a vagina or a penis, that it is about the vagina and genitalia in a surgical context and that therefore photos of the surgery will of necessity include photos of the vagina or the penis as is relevant to the surgical procedure. The graphic is entirely editorial, and unfairly demonstrates a bias on the part of an author that is unfair and un called for in this context. I believe such notices set a socially incorrect precedent that should be reversed. Such notices are inappropriate in a medical context. An encyclopedia for the world should not "cau tau" to the overly prudish, biased, morees of certain absurdly puritanical cultures. Regarding the citation issues, I will repeat that this article is being held to an unfair and entirely biased standard that is not at all representative of the wikipedia and does not serve either its contributors or the likely potential readers of this article about this surgeon. Most people looking for this article will already be at least marginally aware that the surgical techniques Toby Meltzer has pioneered have given him renown among his peers, patients, and potential patients. A google search on "Toby Meltzer" will reveal the countless ocassions on which Toby Meltzer, MD is asked to give public presentations on his work. janniejdoe 20:16, 17 September 2006.

Actually no, it is not obvious to expect a reader on Wikipedia to know what a vaginoplasty and metoidioplasty are about. That is probably why they are reading an encyclopedia--to learn about new things. It is rather POV and Bias to assume that everyone will know what you personally feel is obvious. To a degree that defeats the whole point an encyclopedia, doesn't it? Regarding the photos, you once again are making the assumption that the term "graphic" somehow disparged the subject matter which I think is unfounded. As for the standards this article is being held to, I work with the Good Article Candidates and as an editor to this article, I hold the same expectation for this article as I do with any article I deal with. See the Good Article Criteria. My reasoning is that I want the quality of this encyclopedia to be the highest that it can be. It's just good form. The bottle line is that you are making a claim and for encyclopedic integrity that claim should be sourced. I don't doubt the signifigance of Toby's work but a comment from WP:V sums it up well "The threshold for inclusion in Wikipedia is verifiability, not truth." Agne 03:35, 18 September 2006 (UTC)

First, trying to pull "rank" with me, is not an effective way to be persusive with me or to appear as an ally or friendly. Second, you have misread my statement and missed my major point about vagina and penis. The point is that the article itself explans that a vaginoplasty is surgery to create a vagina. It is therefore obvious that any photographs of surgery in and around a penis or vagina will contain such things in the photograph. I believe that is is entirely appropriate to set the example that photographs of genitalia in medical and educational contexts are appropriate for all audiences. I believe that the precedent should be set that the penis and the vagina or more accurately in most cases the vulva should not be given special attention in medical contexts. To do so, gives the misimpression that there is something "wrong" with human genitalia, which is a falsehood, and an antedeluvian cultural bias whose primitive nature should be abolished. In this century and millenium, is it time for such puritanical prudishness to end. One of the best ironies of discussions about such "warnings" around medical photos is that they primarily serve to heighten the existence and nature of the photographs, and probably invite more study of them than might otherwise occur. In other words, they have the opposite of their intended purpose. The tend to draw more attention to such material, than might otherwise occur, while the tacit intention of people who want to put similarly silly warnings about such material is to "hide" them and be bashful around them. It is high time that humans grow up and get over this silly aversions to the site of human genitalia. The wikipedia should be a place that sets an appropriate standard that medical information should be free from the psuedo censorship that such "warnings" represent. On another note, on the basis of WP:V, a large portion of the wikipedia would be candidate for deletion. I believe such mention constitutes evidence that this article is being given unfair over-attention by a tacit faction whose true purpose is to censor subjects like the sort to which Toby Meltzer and its "Good Article" subject matter relates. First and foremost, such good articles serve to refute the rampant misinformation in the minds of the average populace. janniejdoe 21:17, 17 September 2006.

[edit] Citations regarding surgical technique

I have removed the newly added "citation needed" template since the sentence and its citation accurately speak for themselves. Nobody else could have made his innovations since Meltzer, Biber(retired then died), Shrang (retired - technique different), and Alter (technique different), as their journal papers describe their surgeries differently, and those having been the only major U.S. practicioners, and each of their techniques being notably different. Meltzer's own patient, Marci Bowers, MD, now performs a surgery based on Meltzer's technique, except the labiaplasty is a W-Plasty suture, usualy done in a single stage and without scalloped labia. No other vaginoplasty journal article mentions the Meltzer techniques, and their result photos from other surgeons show the differing results. The request has been made that the citation provide a statement that he "pioneered" his technique. Therefore, I have changed the title of the section as well. I believe this is a reasonable compromise the should overcome what at this juncture borders on pointless pedantry, IMHO. There are no similar articles about vaginoplasty technique regarding any other vaginoplasty surgeon, among the various vaginoplasty surgeons listed on the Anne Lawrence Transsexual Women's Resources site, for the precise reason that Meltzer's technique has been innovative. That is why Dr. Lawrence went to the trouble of standing in during surgery to photograph the entire procedure and create her presentation about it. [1]. Note also that Dr. Lawrence chose Toby Meltzer's patient set for the same reason, among others, when implementing a vaginoplasty patient survey. [2], and her additional notice given Toby Meltzer over other surgeons then practicing as follows: [3]

Janniejdoe 21:26, 22 September 2006 (UTC)

Regarding "...Meltzer developed a vaginoplasty technique that improves over the previous state of the art in numerous ways...": According to whom? Who states that his techniques are improvements over previous techniques? Although you might consider it pedantry, photos do not give self-evident reference to this statement. -AED 22:18, 22 September 2006 (UTC)

Note: And relying on photos to convey this as fact is actually OR:synthesis. What is needed is a reliable source with a direct quote or connection made that Meltzer pioneered/innovated/improved the technique. I'm sure they are out there but Anne Lawerence's photo stream is not it. It's worthwhile as an external link but it doesn't directly support the assertion it's being tagged to. Agne 23:04, 22 September 2006 (UTC)

Agne & AED - I will look in the databases for further references. The latest vaginoplasty techniques of Meltzer, Suporn, Shrang (retired) are cutting edge, and they haven't had timme to write a lot of papers. I will look again through IJT and pubmed for a comparative, historical assay, of vaginoplasty techniques, I will re-phrase this article. These techniques are only about a decade old and still developing. From all appearance Meltzer is doing at least 3-4 vaginoplasty, 1 metoidioplasty, 1 FFS, plus other surgeries every week, so he does not appear to have had time to publish such an article either. It would be very Wikipedian of you if you contributed to the article by scouting and verifying some of the information too. By the way, the 25 page Lawrence article, does contain a requisite amount of text that is worth reading. That is not just an isolated article. It is part an expansive collection by Lawrence, is may be "THE" source on such information in the entire world.

AED - I do very much like the DOB fancy formatting, which is nice to know about. I installed a lot of more links and replaces the see also that I think is helpful to the article, visually nice (rather than a single item section).

Janniejdoe 23:24, 22 September 2006 (UTC)

[edit] Need Assistance Regarding Photo Upload

• I was given a photo of Toby Meltzer, MD by a colleague with permission to make it public domain. I uploaded it, but it has been deleted without comment as follows:

"2006-09-22T15:23:55 Jeffrey O. Gustafson (Talk | contribs) deleted "Image:Tobymeltzer.jpg" (I3)"

• Can anyone provide information, assistance, suggestions, about what to do differently so that it doesn't get deleted? What is the proper procedure in this situation? How do I upload it and designate it public domain?

Janniejdoe 23:41, 22 September 2006 (UTC)

• Can you possibly pmail it to me with details of the photographer? (cooties at mac dot com) I'll upload it with the correct licensing - Alison^✍ 23:51, 22 September 2006 (UTC)

* It is my impression that I must upload it because I am making a declaration about it sourcing, and ability to be made public domain. So .....

It uploaded OK before, but it was summarily deleted without explanation.

• what would be appropriate tags given the above status of a photo?

((Information| |Description = Portrait of Toby Meltzer, MD. |Source = given to me by colleague that created it, who is making it available for public domain use. |Date = (uncertain) approximate 2006-03-01 Permission = "okay for public domain use". |other_versions = none???

((License))

*What else would be needed (except to replace parens with braces)? If I simply had a properly completed template, that actual upload process is a snap. I would like to avoid any unncessary administrative red tape, by getting all the fields right this time. I must do this to learn this, and I hope others will help by WP:AGF.

Janniejdoe 00:01, 23 September 2006 (UTC)