Yeah, I had essentially the same experience about two weeks ago on my first therapy visit. Therapist was listed as a sexual dysfunction doctor, but also had trans checked off. I went in and filled out my paperwork, no pretest or anything, just asked for my insurance and contact info... and now I sort of feel robbed, lol, I'm a little upset that I didn't get a pretest. Anyway, he brought me in and things went well enough. I feel that I articulated everything pretty well. He just asked and said totally obvious things which I've already asked myself. He kind of seemed lost to be honest. I don't know what the hells going on right now, and he really didn't seem to know either, so it was just like, what the hell. At the end he told me that he "might not be my guy," and said there were other places I may do better at. I scheduled another app with him, but I canceled. He was decent enough to tell me that I'd be able to schedule again in the future, but I guess I'm looking for a new one. Hopefully you get your letter if that's what you feels best, good luck.