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 Post subject: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 8:40 pm 
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Backstory: Since age 11, I've been considering and discussing permanant sterilization options with various doctors. I've been laughed at, shut down and basically told to 'think about it' more. So I did, now 11 years later, the results are the same and i'm beyond sure. So my new doctor wrote me a referral to the IWK Hospital OBGYN department so that I could meet with a few doctors and have a better chance of getting information and being taken seriously.

I had my appointment yesterday which involved a length discussion of my reasons, choices options, birth control history etc with a nurse. Then the same discussion with the doctors. Followed by having to do my first ever pap (urg) and then this lovely discussion.

DR: "Well, you have obviously thought about this for a while. And you are extremely well informed, smart, independent young woman. You have done your research. So now, what we need to do is refer you to the mental ward so they can have your mental health assessed."
Me: Come again?
DR:We need to have a mental health professional perform an assessment on your stability and mental state. We need to be sure that your of sound mind making this choice and to make sure there isn't some form of past trauma or event that has lead to you not wanting to have kids. To fully explore the reasons behind your motivations.
Me: I explained my reasoning. This procedure is cheaper and more cost efficient that birth control, it is statistically more effective and it is by far cheaper and less pressure on my body than having a child or more.
DR: So someone will be calling you to book an appointment in the psych ward and they will be test you to make sure everything is ok.

I am too angry to even begin discussing the issues I have with this.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 8:53 pm 
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That is just unbelievable and horrible. I'm so sorry. Is it the law that they have to refer you to a mental health professional? Can you see another doctor?

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 8:57 pm 
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That's forked up, but I'm not surprised. Doctors are rather notorious for not wanting to sterilize young (white) women. You're only 22, so I'm surprised they're willing to even consider it.


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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 8:57 pm 
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yeah, i wonder if it is a law, or normal procedure. from what the doctor said it seems like he understood why you wanted to do it. if i am not mistaken i think in the US you have to go see a therapist before you are sterilized if you are of child-bearing age. that being said, i would think the doctor would have said, "this is the normal procedure".

good luck, that really sucks that you have to go through all this.


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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 9:14 pm 
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The only other procedure I'm aware of that they (typically) make you have a psych evaluation for is gender reassignment surgery.

I get why they do it but it's stupid and it's such a pain in the asparagus. I feel like they should offer it as an option, like they might say "A lot of people find it helpful to get some counseling before undergoing this procedure, is that something you'd be interested in?", but refusing to do it if you don't see a shrink is forked up.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 9:16 pm 
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I am beyond mad for you. It is as though women are only good for child bearing and god forbid they be rational about anything. /rant here
I hope you can get the procedure done. You are wise and have clearly thought this through. And only you know what is best for you.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 9:20 pm 
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kfad wrote:
I am beyond mad for you. It is as though women are only good for child bearing and god forbid they be rational about anything. /rant here
I hope you can get the procedure done. You are wise and have clearly thought this through. And only you know what is best for you.


They often give very young men the same hassle, though. My nephew had two kids by 23 and he and his wife decided that he'd get snipped since it's such a less invasive procedure. They had to jump through hoops to get a doctor to consider it. Not saying that B_A_D's experience is OK in any way, though.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 9:26 pm 
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Sometimes I wonder why they don't make people who want to have children go through a psych eval. You know, to make sure they are of sound mind and understand the decision they are making.


/sheesh.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Thu Oct 21, 2010 9:33 pm 
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LazySmurf wrote:
That is just unbelievable and horrible. I'm so sorry. Is it the law that they have to refer you to a mental health professional? Can you see another doctor?

According to legal aids i've spoken with it is not the law.
I am going to ask about seeing another doctor.

They did cite that it was to make sure i wouldn't come back and sue when I informed her on how ridiculous what she was saying was. Followed by for a voluntary surgery, I don't think you would be able to sue unless they botched something.
However, I would be interested to look into the legal grounds relating to their inquisition into my mental state.

My biggest peeve is that if this were a boob job or a murder trial, my sanity wouldn't be of concern.

I am going to try and find some male friends to look into what would happen if they went in. I've had some people tell me men aren't questions and others say they have to deal with something similar.
Una wrote:
Sometimes I wonder why they don't make people who want to have children go through a psych eval. You know, to make sure they are of sound mind and understand the decision they are making.


/sheesh.

This is what I was wondering. I mean, if the psyche eval reveals i'm psychotic or derange should I really be raising kids I don't want? I mean, if I'm not mentally capable of deciding I don't want kids how am I mentally capable of raising/caring for one?

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 1:43 am 
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I can see both sides of this. I think it sucks and it's a complete violation of your decision-making process as an adult. However, I can also see them wanting to cover their asparagi in case you aren't of sound mind and regret your decision later.

I think it's bullshiitake that the implication (intended or accidental) is that if you want to be sterilized you may be mentally ill. But at the same time, this procedure is potentially irreversible (or very difficult to reverse) and in a weird, perverse way, they're kind of protecting you by ensuring that you're in the proper frame of mind to make such an enormous decision (which "whether I will become a parent or not" is). It's rare, but not entirely unheard of that some people elect for an irreversible procedure such as a gender reassignment or a sterilization and then change their mind later on.

When I started the process of elective sterilization, I had to attend a class that explained my options in great detail and stressed several times that it was irreversible. And the healthcare practitioners and other patients I met along the way were all surprised that I didn't already have kids. I also had to sign a shitload of legal waivers and explain my living situation as well as my partner's feelings about the procedure. People don't want to get sued because some crazy asparagus decides she did want to have kids after all.

It seems you know what you want, and have known for some time. I applaud you for that. If the psych evaluation is not the law, then hell, go for it, ask for another doctor! You live in Canada, USE THAT HEALTHCARE shiitake LIKE IT'S GOING OUT OF STYLE. I would love the kind of access you have! But if it seems like there's no other way to do it, then suck it up and give them their legal escape route. The end result is far more important! Keep us posted, I hope everything goes smoothly from here on out. The sisterhood of barren crones is awaiting your arrival :)

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 4:01 am 
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choirqueer wrote:
I get why they do it but it's stupid and it's such a pain in the asparagus. I feel like they should offer it as an option, like they might say "A lot of people find it helpful to get some counseling before undergoing this procedure, is that something you'd be interested in?", but refusing to do it if you don't see a shrink is forked up.

Agreed, but I'm generally pro-psychologist because I like discussing the shiitake in my head, makes me feel better. I hope it all works out fine for you!

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 4:05 am 
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B_A_D wrote:
My biggest peeve is that if this were a boob job or a murder trial, my sanity wouldn't be of concern.


Una wrote:
Sometimes I wonder why they don't make people who want to have children go through a psych eval. You know, to make sure they are of sound mind and understand the decision they are making.

Yes to both!!!

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 4:17 am 
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As someone who recently went through sterilization, I can honestly see why they do this, though it still peas me off. I didn't have to go through classes or a psych eval, but I had an uphill battle to convince my doctor even at 33. (Even though I had chosen a doctor who is well known for doing the procedure specifically because that's what I wanted. He still wanted to give me an IUD.) At 22, no one would have considered doing it, so in that sense you're really lucky. I'll bet this is the best shot you'll get, so if you can swallow your anger I'd just go through the evaluation. Then again, I'm not one for big ideological battles. I do what I want however I can manage to do it, and fork the rest of it.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 4:22 am 
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Veglicious wrote:
choirqueer wrote:
I get why they do it but it's stupid and it's such a pain in the asparagus. I feel like they should offer it as an option, like they might say "A lot of people find it helpful to get some counseling before undergoing this procedure, is that something you'd be interested in?", but refusing to do it if you don't see a shrink is forked up.

Agreed, but I'm generally pro-psychologist because I like discussing the shiitake in my head, makes me feel better. I hope it all works out fine for you!


The difference there is that you get to discuss the shiitake in your head with a psychologist by your own choice. Nobody's forcing you to go, or threatening to withhold your access to medical care if you don't go. I'm pro-people-doing-things-that-improve-their-mental-health. :)

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 6:55 am 
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I would have been through the roof livid. I've had one of my gynos not take me seriously over a birth control issue and it made me want to scream. So, good on you for looking for a new doctor, although I have to agree with what others have said about these doctors covering their own asparagi. Still doesn't make the situation better.
I wish you lots of luck in this process because it seems you really know what you want and should be able to get it!


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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 8:29 am 
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As others have said, its messed up, and they shouldn't require you to get an evaluation, but hurrah for finding someone willing to do the surgery.

And its crazy as a society that we 1) treat women like we can't assume that a sane woman is able to consent to sterilization (because of the magical myth of motherhood) but can do so for a ton of expensive plastic surgery (because wanting big boobs in normal) and 2) put so much pressure on women to bear children into an overpopulated world.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 9:03 am 
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Hearing this really peas me off, it shows how little control we really have over our own bodies.

Tofulish wrote:
And its crazy as a society that we 1) treat women like we can't assume that a sane woman is able to consent to sterilization (because of the magical myth of motherhood) but can do so for a ton of expensive plastic surgery (because wanting big boobs in normal) and 2) put so much pressure on women to bear children into an overpopulated world.

This

My friend went recently to make an appointment to get a vasectomy, he's 30 and he's already had 4 kids. The doctor turned him away and told him that he's still young and may want more kids in the future. My friend may be young but he's pretty damn sure that he doesn't want anymore kids! He was really mad about the whole situation.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 9:28 am 
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I know this isn't the same, but these sorts of evaluations are one of the hoops that responsible surgeons make gastric bypass patients jump through. I resented it, and actually ended up having three separate because each surgeon I saw wanted their own doctor to do the eval. One of the psychologists even denied me for unspecified reasons, although the other two both said I was a great candidate.

I really resented this requirement at the time, but I now appreciate it having met so many people who have had the surgery. I would say that at least half of the people I've met were not properly equipped or ready to deal with the surgery with the result that they gained all their weight back, developed health problems, or otherwise have ended up badly off and now many of these people are walking examples of why insurance companies hate to cover it. I think that a lot of these issues might have been avoided with better mental health counseling both before and after. In retrospect, I was very lucky that I had a surgeon who was so scrupulous about every aspect and recognized that this surgery was far more than physical.

Again, I know it isn't the same thing, but I imagine that sterilization is emotionally charged for many people, so maybe some doctors require this based on their previous experiences? From what you said, it doesn't sound like the doctor you saw was condescending or not taking you seriously. It sounds like like you were treated with respect. (If this was not the case, then I misinterpreted your post, which would probably change my thoughts here.)

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 9:29 am 
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I think you should go and act as wacked out as possible, and at the end of the appointment say "Clearly, I shouldn't be reproducing."

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 9:32 am 
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Eta: a post-gastric bypass friend also had to do an eval before plastic surgery (boobs and tummy tuck) even though it was all reconstructive.

I would be pissed about this if it seemed limited just to reproductive issues, but I think a lot of surgeons are just very cautious, which is actually a trait that I love in my surgeons.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 9:36 am 
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And to think I was mad at my Gyno for telling me I was too young to get an IUD!

This is crepe, but I'm sure the doc is trying to cover the bases of not having a lawsuit creep up in the future. Not fair to you, but probably smart on the doc's part.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 11:56 am 
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-1 Yummy, for sure.
(Ugh. Like you, I can't even begin.)
(Also, ditto what Tofulish said.)

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Last edited by lutin on Fri Oct 22, 2010 3:33 pm, edited 1 time in total.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 1:13 pm 
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I see why they do this but it must be really annoying for you.

In the UK a test of a person's capacity to make a decision is carried out by the most suitable person, in your case it would be the surgeon who agreed to operate on you. You've already evidenced that you understand the procedure, the consequences etc. Psychiatrists aren't magical people who can suddenly decipher the meaning of a person's behaviour, they diagnose mental illnesses and prescribe meds! Your own doctor should be able to ask the questions to determine whether you're doing this because of some inappropriate reason or because you've made a rational choice about your own body!


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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 1:15 pm 
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We were just talking about this sort of thing in one of my classes last night. Freaking ridiculous. I'm sorry they're treating you like that.

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 Post subject: Re: So now I need to pass a psychiatric evalutation....
PostPosted: Fri Oct 22, 2010 1:20 pm 
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It is ridiculous. I hope there are no further hurdles for you.


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