Initial Intake:<br/><br/>Age: 15<br/><br/>Sex: Non-binary&nbsp; &nbsp; &nbsp; &nbsp;<br/><br/>Gender: chose not to answer<br/><br/>Sexuality: chose not to answer<br/><br/>Ethnicity: East Indian<br/><br/>Relationship Status: Single<br/><br/>Counseling Setting: Community Outpatient Clinic<br/><br/>Type of Counseling: Individual<br/><br/>Presenting Problem:<br/><br/>Shar was brought it by their mother, Nadia, for concerns about being isolated and argumentative.<br/><br/>Mental Status:<br/><br/>Shar is 15-years old and looks younger than stated age due to their weight. Shar had a flat affect throughout the interview and looked down frequently. Despite there being an empty seat on the couch next to their mother, Shar sat in a chair across the room.<br/><br/>History:<br/><br/>Shar and Nadia reported that they used to have a close relationship. There have been no issues or discord until now. Recently, Nadia noticed Shar staying to themself more in their room, which is unlike them. Shar recently lost a significant amount of weight and teachers reported their grades have declined. Nadia shared problems started when the topic of the sophomore dance came up and Nadia asked Shar what boy they were going with.<br/><br/>When this topic came up during the intake, Shar rolled their eyes at this and stated, “Mom, you are so narrow minded. Why do I have to go with a boy, why can’t you just ask me WHO I am going with?” Nadia looked at the counselor and stated, “Do you see why I brought her here? She is so disrespectful, and she is lucky that her father did not hear her say these things. We used to be so close.”&nbsp;<br/><br/><u>Session One</u><br/><br/>Information gathered at intake showed that Shar displayed desire to be a boy at an early age and would often want to dress in “boy” clothes as opposed to dresses and wanted to urinate standing up, instead of sitting down. Nadia brushed this off as Shar being close to their father and having “tomboy” like characteristics. It wasn’t until Shar went through puberty that they began making comments such as wanting to cut off their breasts. Shar would also get angry when filling out any kind of forms where she had to identify their gender, stating that she wished that she could fill out anything else but female. Shar asked if their mother could not be around for the session. Shar shared with the counselor that they never felt like they belonged anywhere. Ever since Shar was young, they have felt out of place, like there was something wrong with them. At first, their parents tried to discourage them from wearing “boy clothes” and participating in activities normally reserved for boys. Shar's friends throughout elementary school and junior high accepted them for who they are. However, once Shar entered high school, they were bullied for appearance and since then, lost their group of childhood friends. For the past few months, Shar has had feelings of sadness and hopelessness, has had difficulty sleeping and feels guilty for the obvious distress this is putting on their parents. After the session, Nadia asks the counselor if she can share with her what Shar said.<br/><br/>At this point the counselor should: