A University of Miami surgeon has lost his job after sharing graphic images of his transgender patients without their permission.

Christopher Salgado, a genital reconstruction surgeon, was discovered posting the images on his since-deleted @sexsurgeon Instagram account, Trans Advocate reports.

Salgado, who has worked with transgender people for many years and given talks and presentations to other medical professionals on transgender healthcare and gender confirmation surgery, was found to be mocking his patients through questionable images, captions and hashtags.

In one post for Valentine’s Day, Salgado took the recently removed penis of a transgender woman, fashioned it into the shape of a heart, and wrote: “There are many ways to show your LOVE…”

He then added various hashtags, including #whatisthat, #whatthefuck, and #whatthefuckisthat.