Kate, I am not that different than you in my place in the process, just a little farther along in life.
I questioned the role and need for a therapist as well (question her all the time as to what indeed she provides me), but use her as a tool in the journey. I mirror the comments that it is really about me telling her the pace I need to move forward.
In the four short months I have seen her, I have always questioned her role, and my needs to use her in the process. I have a timeline I plan on executing from telling the spouse, to seeing an Endo, to starting HRT. The Therapist just gives validation that I understand all the difficulties in my life and how they relate to executing a plan; that steps are being met. I have come to realize that Therapists do not offer answers, but are a safe talking environment to vocally work out your plans and processes to validate you are ready, especially when you really have no one else in your current environment that you can talk with about all facets of your life and needs. That's all she is or does, and I guess that's her role.
I don't necessarily want to take the time, or spend the monies it takes to be in therapy, but realistically, besides typing in this site, there really is no one that can question or affirm that I understand what/who I am, the significance for needing/going forward with the goal to aligning myself with the natural conclusion.
Therapy moving forward after starting with HRT soon, probably more invaluable. No one knows how their personal journey will happen in the future; it could be fast and spectacular, nothing good whatsoever, or somewhere in between (likely). This is where I will need a sounding board, someone that I can talk about my frustrations in the middle ground of my transition between what I am today and what I envision I would like to become. This is where the ground work of establishing my relationship with my Therapist becomes clear to me. What she is now and what she provides, I believe, is nothing in comparison to what she will be for me when I am awkward, questioning, frustrated, confused in the first 15 months of transition.
She agrees I am ready to begin and after I asked, suggested a renowned Endo for me. But it was after we talked that I realized that it will only be always based on showing my initiative is understood and warranted.