Are you agender? I'm not sure I am, but something in that direction. Sadly some therapists and even other people treat people with a BPD label very poorly, like they think they need to be overly cruel. I think it is fantastically horrific of a therapist to sweep this under the rug and call it confusion.

Gender identity can change through life. Or someone can always be trans/non binary or what else, but it is not equally strong in different parts of life. But none of that is confusion. It's a total put down calling it that.

I think it might say more about the therapist's political or religious standpoint than knowledge and common sense.

I'd say, there is no bad way of lifting the topic. There is just a good or bad response from the therapist. It will be more of a test how a good therapist they are.

Also they should know, not being cis, is much more common in autism.

And about the boob thing, I totally hear ya. If I didn't fear surgery id at least have them reduced to an A cup. I'm sickened by breasts. Well, maybe not other people's, although I wish we were more like cows. That they just grew out if we had babies. Makes more sense.

I hope it goes really well for you.