Psychiatric Hospitalization: Research Study

[Rena-san]

Hello,

So I'm writing a research study proposal for a class. As such, this study is 100% pretend, imaginary, fake, NOT REAL.

But here is what I was thinking, and I just wanted to collect some varying/supporting opinions: what if instead of the usual WPATH hoops to jump through to qualify for surgery there was a hospital that admitted patients seeking GRS, or even just hormonal access, to psychiatric hospitalization. After successful evaluation and completion—and once the diagnosis of GID could be confirmed—the patient would be allowed to proceed with sex-transformation treatment. In fact, the patient would be offered treatment as though it were as simple as changing medicines or being administered ECT. 

In such a study, the independent variable would be the length of psychiatric hospitalization prior to sex-transformation services: ranging from 0 hours all the way to 168 hours with partial hospitalization and 72 hospitalization in-between. This variable would be undisclosed to participants with those randomly choosen for 0 hours held to WPATH standards. The dependent variable would be patient satisfaction/if they choose or were considered eligible for sex-transformative treatment after psychiatric hospitalization. Patient satisfaction would be determined by post-op surveys given 6 months, 12 months, and 24 months after treatment.

With such a study, there would be grant funding and all services would be provided free of charge to consenting and complient participants. I think such a study would be beneficial as it would give patients suffering from GID a safe and secure place to discuss and work through some of the major issues they are experiencing. It would give them the chance to develop a treatment plan that meets their needs and to do so in a medical setting with skilled and experienced doctors. Also, there are those people who GRS is perhaps the worst thing they could be allowed to do. With mandatory evaluation prior to services, perhaps these individuals could be spotted and offered a different treatment plan.

Again, this is all imaginary. Resources are scare, yadayada, such a program would never work, yadayada, but that's not the point of this assignment. The point is to write a hypothetical medical research grant proposal. 

I want opinions based on what I've provided. Would you participate in such a program? What are the pros? The cons? Can you identify any possible flaws or problems with this idea?

[stephaniec]

well, to honest I already have found easy access to extremely excellent  profession care and HRT without any stipulations and with Medicaid my treatment and even GRS is free or will be in the near future. I know I am extremely fortunate , but it already exists. As a side note if your studying to be a psychiatrist or other health care professional , I'd like to say that ECT is a barbaric form of treatment, not to be taken offensively , but I have a very strong opinion of ECT.

[Eris]

I thought that the only purpose Electroconvulsive Therapy still served was in attempting to nullify Epileptic fits and seizures, like severing the connections between hemispheres of the brain.

[Dee Marshall]

Never in a million years would I participate, recommend, or condone such a system. Psychiatric hospitalizations are for tier one diagnoses. GID is not tier one. In any given day those facilities are populated by people with schizophrenia, psychosis, bipolar disorder. Seriously Ill people. Besides the strain of spending your day associating with very ill people at a time when they are vulnerable and symptomatic, such a system would stigmatize a population, us, whon do not need to be further stigmatized. It would also take beds in facilities already overstrained to meet the needs of the people who currently need them and subject us to medical professionals in an environment where they are inclined to look for the quick fix.

Don't think that I fear, disrespect, or dislike the mentally ill. I spend 40 or more hours per week in their company. Some of them are transgendered in addition to their illness. Some, many, of my colleagues treat anything out of the norm with them as pathology. It's very hard to be GLBTQ and mentally ill, we don't need people equating the two again. We just won that battle.

[Dee Marshall]

ECT is also used to reduce the impact of traumatic memories.

[stephaniec]

ECT is also used to reduce the impact of traumatic memories.

I can definitely understand the use for wiping out memory

[Jessica Merriman]

The public at large would never approve funding for this project. 

[mrs izzy]

It is the old question if you could take a pill would you? That is one question most therapist ask there GD clients.

If only life was that easy we would not have cancers, health issues and other mental disorders

Only thing is science can never guarantee anything past 99%

My question i asked if there is a pill then what is the cause?

Isabell

[Jessica Merriman]

My question i asked if there is a pill then what is the cause?

That blew my mind! you rock Sis!!

[Randi]

Wouldn't the study require a control group?  What happens to them?

Is there some sort of placebo hospitalization that could never result in a change?

[Bombadil]

Ok, my gut level reaction was "heck no!". But skipping my own emotional response for a moment...

why would you want to isolate transgender folks from the general population? As much of the challenge of transition is dealing with society, work/school, loved ones, etc wouldn't hospitalization miss the point to a degree? often times, isn't the most support needed when you are learning how to interact with others through the time of transition? you wouldn't get that in a hospital setting.

perhaps, for the sake of your argument a partial hospitalization program would make more sense but I still don't really see the benefit. I also wondered about what Randi asked.

[kira21 ♡♡♡]

That is one crazy proposal! Ect for trans issues? Sounds 1950s! I did a mental health qualification in the UK recently and it can still be used for extreme depression. 

Basically, it depends where you are conducting the study. In the UK it would need to be ran through a research and ethics council and I don't think it would get through as,  to me your study just isn't ethical!  Besides,  it seems to be approaching trans issues from a dated perspective that it is a disorder,  when it is I believe listed as a condition and your treatment of Ect is not established as being effective and has very high risks. We are not crazies that you lock up and electrocute! Psychiatric hospitalisation is for those who cannot function in public.  Personally I would find a real life implementation of your idea offensive and dangerous. 

Kira x

[Sammy]

Well, apart of ECT (at least I hope so), this is the system we have here. No GICs, no gender therapists, nothing. If You want to be diagnosed F64.0 then You must apply to the psychiatric hospital (which is a closed type medical institution which deals with mental disorders and drug addicts) and undergo an interdisciplinary examination. I have no idea if You are allowed to leave the premises before they take decision on You, but this kind of attitude just made me to rebel, but since I could not anything I just circumvented the system. Plus, You have to pay the costs and once diagnosed, You just get a paper and can start scratch Your funding for next steps - endo, HRT, lab tests, SRS etc etc etc.  Maybe we will be able to change this system, but IMO, ICD needs to be updated and F64.0 taken out of its psychiatric section before we could argue that psychiatrists should have no saying over this.

[immortal gypsy]

I thought that the only purpose Electroconvulsive Therapy still served was in attempting to nullify Epileptic fits and seizures, like severing the connections between hemispheres of the brain.

No!!!! Trust me if that was the case you wouldn't get me anywhere near a hospital. It can be hard enough getting me to go to hospital now after a seizure, add that and THERE WOULD NOT BE A NEUROPHYSIOLOGY WARD STANDING after I was done

<calm blue ocean, calm blue ocean Tidal Wave>

The problem with your proposal is your are missing a key part called 'real life experience'. We are all not cookies cut from a mould we all have different levels of dysphoria. Some need GRS some HRT is enough, but I could probably assume we all wish to blend in and disappear into what ever social network we choose. Now visits to doctors and hospitals are sometimes not so easy to cover up as 'everything is okay here folks nothing to see here move along'. A regular extended stay that can be near impossible, adding additional unwanted stress to people who want to remain as stealth as possible.  How are they going to cope with the extra stress, one or two visits you could MAY be able to write of as a anxiety attack but it can attract another stigma you don't need with more pressure that goes with. Why would you want to transition when even tho you need to the path one must take, is worse than the road they are on now.

Yes this is for a class project but by Cthlulu I hope this never becomes a reality

[stephaniec]

Hello,

So I'm writing a research study proposal for a class. As such, this study is 100% pretend, imaginary, fake, NOT REAL.

But here is what I was thinking, and I just wanted to collect some varying/supporting opinions: what if instead of the usual WPATH hoops to jump through to qualify for surgery there was a hospital that admitted patients seeking GRS, or even just hormonal access, to psychiatric hospitalization. After successful evaluation and completion—and once the diagnosis of GID could be confirmed—the patient would be allowed to proceed with sex-transformation treatment. In fact, the patient would be offered treatment as though it were as simple as changing medicines or being administered ECT. 

In such a study, the independent variable would be the length of psychiatric hospitalization prior to sex-transformation services: ranging from 0 hours all the way to 168 hours with partial hospitalization and 72 hospitalization in-between. This variable would be undisclosed to participants with those randomly choosen for 0 hours held to WPATH standards. The dependent variable would be patient satisfaction/if they choose or were considered eligible for sex-transformative treatment after psychiatric hospitalization. Patient satisfaction would be determined by post-op surveys given 6 months, 12 months, and 24 months after treatment.

With such a study, there would be grant funding and all services would be provided free of charge to consenting and complient participants. I think such a study would be beneficial as it would give patients suffering from GID a safe and secure place to discuss and work through some of the major issues they are experiencing. It would give them the chance to develop a treatment plan that meets their needs and to do so in a medical setting with skilled and experienced doctors. Also, there are those people who GRS is perhaps the worst thing they could be allowed to do. With mandatory evaluation prior to services, perhaps these individuals could be spotted and offered a different treatment plan.

Again, this is all imaginary. Resources are scare, yadayada, such a program would never work, yadayada, but that's not the point of this assignment. The point is to write a hypothetical medical research grant proposal. 

I want opinions based on what I've provided. Would you participate in such a program? What are the pros? The cons? Can you identify any possible flaws or problems with this idea?

if I may ask , are you part of the trans community or just a student searching the web. No offense just curious.

[stephaniec]

I could be taking this wrong , but it sounds like your proposing institutionalizing transgenders or those who think or behave as transgender then arbitrarily deciding first of all who gets treated. The chosen and the ones who get sugar pills are then indeterminately institutionalized to be subjected to a small group of psychiatrists who will determine whether or not you  get GRS. Which seems to be the intended cure offered for free with no gradient of options. It seems like herding the cattle in to the slaughter house and diverting the diseased cattle to one pen and the healthy to another with a small group of over seers determining who's healthy and who's not by an arbitrary rule defining health. Please this is not intended to be anything other then my opinion of what your proposing . I might be completely misunderstanding your proposal and if I am  truly sorry for misunderstanding.

[JennyH]

There are parts of your proposal which I actually like and could agree with. I have actually gone into a voluntary inpatient psych ward on three different occasions all of them occuring over a six month period and each being about 2 weeks in duration. When I first started going in it was in regards to severe clinical depression and suicidal ideation/ attempts as I was able to clinicians there it slowly came out that the reason behind this was gender dysphoria which I had been repressing since an early age. The people I met there were some of the nicest I have ever met they were sick, knew it and were there to get help. My experience was that thee most help you receive is not from the clinician but the group therapy sessions and your daily interactions with other patients. In regards to your plan I would support the hospitalization idea for the initial diagnosis but then outpatient treatment for everything else.

As far as ECT goes it has come a long way from the 50's and is considered an effective treatment for seizures, PTSD, and severe depression in cases where antidepressants have not worked. ECT works by causing a grand mal seizure in the brain causing the brain to rewire certain neurological pathways. This can cause temporary short term memory loss and mobility problems. I have met several people who had received the treatment and were undergoing the treatment and they all said that it gave them their lives back. Ect is not for everyone but for those who do need it it is a miracle.

[Colleen♡Callie]

A) I think switching to a method involving psychiatric hospitalization undermines the fact the field of psychology no longer deems GD as a psychiatric disorder.

B) HRT is a slow process requiring years to work and thus would be impractical to ask people that can fully function in society to remove themselves for years and can be problematic upon returning to society after such an absence.

[stephaniec]

A) I think switching to a method involving psychiatric hospitalization undermines the fact the field of psychology no longer deems GD as a psychiatric disorder.

B) HRT is a slow process requiring years to work and thus would be impractical to ask people that can fully function in society to remove themselves for years and can be problematic upon returning to society after such an absence.

that's what I thought was being proposed

[allisonsteph]

My experience with psychiatric hospitals tells me that this is a horrible idea. I've been hospitalized twice in the last two months due to suicide attempts and there are some seriously ill people in these places. It was downright frightening. It was traumatizing. I think it was an extreme environment for me, a person declared a danger to self and others, to be placed in. Placing someone suffering from Gender Dysphoria in one of these facilities would do far more harm than good.