[paperwasp42]

It depends a lot on the publishing house and editor you're working with. I have heard of editors who allow for sensitivity reader suggestions to be ignored, and some who are quite militant about enforcing all suggestions from sensitivity readers.

There seems to be little rhyme or reason behind how strictly the edits are enforced. (e.g.: One friend got to keep a very crude weight-related joke that a sensitivity reader wanted to remove, because she convincingly argued that it was needed to show-case the character's dark side. Another friend was aggressively forced to remove her teen protagonist's insecurity over having freckles, because it "encouraged low self-esteem and depression" and would be "damaging" to the audience.)

The difficulty with disagreeing with edits of any sort is that publishing is a reputation based industry. So if you put up a huge fuss and escalate issues up the chain of command, and possibly even involve the public, there is a chance you can resist even the most aggressive attempts to edit your work. But you will absolutely ruin your chances of another book deal.

For this reason, it's frustrating to hear the typical retort of, "Well no one's actually forcing authors to change anything, and they have the ability to protest, so it can't be censorship." This is like telling a junior engineer at a large company, "Well no one forced you to write that code. You had the chance to disagree with the design and write the program differently." Sure, no one physically forced them to write the code, but did they really have the option to balk at the design handed down from senior engineers and management? Of course not. It would be career suicide.