Hi Arch Like you Arch, I'm the same when discussing my past even in front of my family. It is: "When I was little," "when I was four or five," or something similar. That is how I talk about myself to family or friends who don't know. If I have to use pronouns I will use her or she, as they are the most common pronouns.
Why? Because I have always been a female. Even a childhood memory tells me that I was a female (I just made the connection recently). Even before I changed my life around I never referred to my gender, not that I can recall doing so.
I have been using those pronouns since 1989. Twenty-one years later, in 2010, I realised I was a female after joining Susan's, yet even then I rarely had to refer to my gender except on forms.
I still do not express my gender outside Susan's. There is no other rationale; using any other pronouns would feel foreign to me.
In the case of a therapist, if I were seeing one and discussion revolved around my medical condition, I would ensure they were a 'gender specialist' and I would insist that they use the right pronouns. I would feel extremely uncomfortable if they did not. If they persisted, then I would seek another therapist.
Best Wishes AlwaysSarah BGlobal Moderator@Arch