A good therapist will ask, what seems, very unrelated question as to why you are there. Then he/she will begin to delve into the real reason you are there. The first 2 sessions were a "feeling out" period. So that the therapist has a short bio of your life, so that they might have an immediate grasp of the situation you now might face.
It's sort of like I told my therapist a couple of weeks ago. When I first went, I was hoping she would find another reason for me wanting to feminize to whatever degree that is, to be a fad, boredom or a form of suicide. She has ruled out that, and instead thinks I am of the " Third Sex " or "Two Spirit".
So, in short. A good and conscientious one will definitely start in a very neutral place. Then try to figure out if it was upbringing, purely late onset or, just a fad. Or, in my place, I was born a 2 spirit and just kept myself too busy to realize it.