Overturned
Testicular Cancer Self-Check Infographics
June 4, 2024
A user appealed Meta’s decision to remove a Facebook post that contains infographics providing instructions for testicular self-examination.
Summary decisions examine cases in which Meta has reversed its original decision on a piece of content after the Board brought it to the company’s attention and include information about Meta’s acknowledged errors. They are approved by a Board Member panel, rather than the full Board, do not involve public comments and do not have precedential value for the Board. Summary decisions directly bring about changes to Meta’s decisions, providing transparency on these corrections, while identifying where Meta could improve its enforcement.
Summary
A user appealed Meta’s decision to remove a Facebook post that contains infographics providing instructions for testicular self-examination. After the Board brought the appeal to Meta’s attention, the company reversed its earlier decision and restored the post.
About the Case
In April 2019, a Facebook user posted four screenshots of infographics titled “How to check your balls (testicles).” The infographics explain the steps to perform a testicular self-check, providing written and visual guidance on how to look for lumps or changes in testicular size. The illustrations include drawings of a man using his hands to examine his testicles. The user included the following caption: “have you given your balls a squeeze this month?”
Five years after the image was posted, Meta removed the post from Facebook under its Adult Nudity and Sexual Activity policy. Within that policy, Meta states that it removes sexual imagery by default, with an exception for (among other reasons) medical or health contexts, specifying as an example, cancer or disease prevention/assessment. The user, in his appeal to the Board, affirmed that “the set of images were clearly a medical infographic” and did not portray adult nudity in violation of the Community Standard, but instead was information shared in a medical or health context.
After reviewing the case, Meta concluded that the content did not violate its Adult Nudity and Sexual Activity policy, and restored the content to Facebook. The company’s Community Standard allows “imagery of visible adult male and female genitalia, fully nude close-ups of buttocks or anus, or implied/other sexual activity shared in an educational or scientific context such as sexual health or medical awareness.” It remains unclear to the Board why Meta removed the content five years after its original posting date.
In his appeal to the Board, the user clarified that the post was prompted by Facebook Memories, an album posted several years ago without any issues. As a cancer survivor, he considered Meta’s decision unfortunate and worrying; the user explained his intention was to encourage men to conduct testicular self-examination regularly as this is the main reason why many men fail to detect early signs of cancer.
Board Authority and Scope
The Board has authority to review Meta’s decision following an appeal from the person whose content was removed (Charter Article 2, Section 1; Bylaws Article 3, Section 1).
When Meta acknowledges that it made an error and reverses its decision on a case under consideration for Board review, the Board may select that case for a summary decision (Bylaws Article 2, Section 2.1.3). The Board reviews the original decision to increase understanding of the content moderation process involved, reduce errors and increase fairness for Facebook, Instagram and Threads users.
Significance of Case
This case highlights Meta’s failure to enforce medical and health exceptions consistently as described under its Adult Nudity and Sexual Activity Community Standard. Creating awareness of and promoting testicular self-screening is crucial for the early diagnosis of cancer, and social media is essential to this effort. This case highlights the necessity of accurate moderation to facilitate awareness about testicular cancer and other diseases for educational or medical reasons.
The Board has previously issued recommendations to Meta on its policy related to nudity in a health awareness context. The Board asked Meta to improve the automated detection of images with text overlay to ensure that posts raising awareness of breast cancer symptoms were not wrongly flagged for review, ( Breast Cancer Symptoms and Nudity, recommendation no. 1). The Board has also urged Meta to “implement an internal audit procedure to continuously analyze a statistically representative sample of automated content removal decisions to reverse and learn from enforcement mistakes,” (Breast Cancer Symptoms and Nudity, recommendation no. 5). In response to the first recommendation, Meta demonstrated its implementation through published information. For recommendation no. 5, the company reported this as work it already does but did not publish information to demonstrate implementation.
Furthermore, the Board stressed that users should be able to appeal automated decisions when their content is treated as a violation of the Adult Nudity and Sexual Activity Community Standard. These decisions should then be reviewed by a human reviewer to ensure that over-enforcement of this Community Standard is not being used to prevent other harms on the platform, ( Breast Cancer Symptoms and Nudity, recommendation no. 4). Meta reframed this recommendation in its initial response, when it said it would assess the feasibility of implementing it. However, later in the quarter, Meta declined to take further action on the recommendation.
The Board emphasizes that full implementation of these recommendations will help Meta to decrease the error rate of content incorrectly removed under the health and educational exception of the Adult Nudity and Sexual Activity Community Standard, allowing users to raise awareness and educate themselves about early symptoms of testicular cancer.
Decision
The Board overturns Meta’s original decision to remove the content. The Board acknowledges Meta’s correction of its initial error once the Board brought the case to the company’s attention.
