Keep in mind that the therapist got to observe MsVal in the support group setting as well.
Some therapists blurt out the obvious, some don't. The therapist my wife saw about me, as she tried to understand what I was going through, listened to her describe me for an hour, and told her that it was a near certainty that I'd transition, and ultimately seek SRS. He was right on the money, too - although I sure as hell didn't want him to be.