You're not alone in having thoughts such as these. I have them all of the time. They're very overwhelming and a contributing factor as to why I hate myself.

I think if you told your T, it wouldn't be cause to hospitalize you. Especially, if you have no intention on acting upon the thoughts. You may get a med increase, but it's not suppose to be punishment. It's meant to help you so that you're not stuck with these thoughts. I'm also familiar with that look people can give. I hate that look. But if you get all of this handled through therapy, there shouldn't be any cause for hospitalization and you might not even need a med increase.