Hey Warren,
I have a lot of thoughts about this. First, you are doing the absolute correct thing by writing about it here. We are here to listen and to help as best we can. Second, I completely understand your hurt, anger, and disillusionment with your therapist. How she could demand that you spell out your goal for therapy is beyond me. I was angry myself when I first read your post.
After I calmed down I thought, well, maybe you could give her some goals. Here are some ideas. Obviously (I hope) you are the only judge as to their accuracy for you. I just hope they trigger some ideas:
1. Relief or ways to handle depression.
2. Help with sorting out and planning what to do with your gender expression.
3. Understand what is driving you to hurt yourself, and, learn and implement ways of handling those issues without having to hurt yourself for relief.
4. Help with understanding how you can talk to your family, and, if it doesn't go well, counseling on how you will deal with this.
5. Same thing with your boy friend. This is important, whether or not you stay together. If he leaves or you break up there will be another one.
Please do not cancel next week's appointment. These goals are all very important for you. I suggest you write down more, maybe come up with a crazy long list, and then you can consider combining and prioritizing.
While I don't think the therapist was tactful or kind, she does have a point. You and she are a team. And as a team, you both need to know where you want to go, what it means to make progress and succeed. So her question is okay even though very poorly presented.
Let's keep up the discussion.
Emma