If any trans women here have been admitted to a psychiatric ward, I’m looking for advice/experiences. My main concerns are the following:
- Losing access to DIY HRT
- Inability to shave, or is I can shave, having to be watched while doing it
- Being strip searched
- Transphobia from other patients and staff
- Food
Context - I live in a blue part of Washington State, fairly progressive, and I’m working with my therapist to get a personal recommendation for a facility (she mostly treats LGBTQ+ patients, so I’ll be asking specifically about that).
I currently take Estradiol Cypionate by injection, once per week as monotherapy. I’ve used a tool to estimate my E levels, and I’ve determined I could likely go 14 days before things get bad (below 100pg/mL), but obviously that would not be an ideal experience for me hormonally. I just tested my levels last week and my E came back significantly higher than I expected (could maybe go longer than 14 days), and my T levels were incredibly low (16ng/dL). So much so that I was planning to reduce my dosage this week, though I think I’ll wait to reduce until after my stay in case it lasts longer than I expect. I am almost 100% not going to be able to get them to administer my DIY hormones to me, but if anyone else has had this experience, please comment. I think I’ve rationalized it enough that I wouldn’t be devastated if I were denied access (or more accurately, when I am), assuming my stay isn’t longer than 2 weeks. I’m worried that they’ll see them and throw them away instead of just locking then up, which would be a big problem because shipping would take about 2 weeks and I don’t even have the money for it right now.
However, I am quite concerned about shaving. Since I’ll be a voluntary admission, I’ve heard there’s sometimes leniency for supervised face shaving, but I’m also worried about being able to shave my body. Granted, I’ll be wearing clothes that cover up all my skin, but the feeling of being unshaven is incredibly dysphoric for me. I could live with it, except for genital hair. I unfortunately have extremely sensitive skin, and I’m pre-op, so if I don’t shave for a few days, I will get intense chaffing and irritation, which is the most dysphoric thing I have ever felt in my life. I would be in genuinely severe mental distress having to live like that. But even if I were granted some exception to let me shave there…I’d have to be supervised. And I’m having a really hard time trying to mentally prepare myself for someone watching me shave naked. Especially because I don’t know if I’ll be allowed to ask that it be a woman that supervises. I’ve been told it varies wildly from place to place for strip searches, and I assume it would be the same case here.
And then…there’s being strip searched. Again, no idea if I can decide if a man or a woman watches me strip and reveal every square inch of myself, which is horrifying. I would feel mildly less mortified if my genitals matched my gender identity, but…I’m not there yet.
The fear of experiencing persistent transphobia while I’m there is also incredibly present for me, especially given that I’m nowhere close to passing. This will be my first time publicly presenting femininely but I think it’s what’s best for my mental health because it’s exhausting having to hide myself in person when I have been open online for almost a year now, and on HRT for 5 months as of today. The only thing holding me back has been living with transphobic parents with a long history of abuse. There are two angles to the transphobia fear. The first is that there may be other patients admitted who are transphobic, and in severely deteriorated mental states, and the second is that staff could be transphobic, and they hold an immense power over me as a patient. Both are terrifying to me, and I don’t know how I would deal with it.
And perhaps something more inconsequential is food. I have a milk allergy, so I’d need that to be accommodated, and I’m also autistic so I have a lot of food triggers. I’m worried about not being able to eat enough, to be honest.
None of these things are going to prevent me from admitting myself, I know I need help right now, and I need serious intervention to be able to recover and to keep myself safe…from myself. I’m not going to get into the details because that isn’t what this post is about, I’ve just been having some anxieties about what it’s going to be like, and the chances of me leaving the hospital severely traumatized.
If any of you have been through it, what has it been like for you? Any advice?
Thank you for your detailed response! I didn’t get into depth in the post because it wasn’t what I was looking for, but I have been actively suicidal for over a week now, and things have only gotten worse and worse. I understand it’s a place where all my privileges are lost, and honestly, that’s what I need. I already have a go bag of non-restricted items ready to go. I’m not able to work, I’m not able to take care of myself, I’m relapsing on nicotine, alcohol, and cannabis (which I was sober from since New Year’s Day 2024), and I don’t feel safe in my own home (transphobic parents who were severely abusive in my childhood), so it isn’t a place where I feel I can even recover. My medications aren’t doing shit, and I’m not able to see my psychiatrist enough to get it sorted out. I think what I do need is a place where I can fall to pieces for a week. Somewhere I’m not allowed the constant addiction of my phone which only ever triggers my spirals, but never alleviates them. A place where I can be kept safe from hurting myself, because I cannot trust myself to take that job on my own shoulders anymore.
I’ll need to work out insurance details (though my insurance currently has covered all my psychiatric care in full; not even a copay), and I trust my therapist to find the best place for me, and I’d trust her opinion on whether or not I should go. I’ve heard lots of experiences similar to yours online. Although seeing a psychiatrist can range from weekly to daily depending on facility. I’ll look more into the details of stay length, and I do know I need to ask my insurance about that because they may only cover the first X days, but I do already expect it to be expensive. But being in a state where I cannot even care for myself, let alone work, has proven to already be extremely expensive in itself.
I gotcha, well if you have any other questions I’m glad to answer as best I can :) I hope it does help tho. I haven’t been in the hospital for a while so maybe my advice isn’t great but if you’re interested:
Depression for me felt like a narrowing of perspective. At that moment everything was how I felt right then. It was how I always felt and how I would always feel. Essentially I felt like life had always been awful, and would always be awful, because it was awful right then. Everybody is different and has different reasons they’re struggling, so I’m not trying to make blanket claims too much, but I think it’s safe to say that change in life is inevitable. Sometimes the best we can do is hang on and wait for the next change.