Seems like you might want to have an open discussion with your therapist about how and why their note taking process works.

My wife is a therapist and they have a large number of trans and gender nonconforming clients. Earlier this year they had a series of meetings to work through how to change the diagnostics and hide any notions of gender dysphoria of their clients to not tell insurance about it at all. Most therapist offices are doing the same thing.

Just to note if you therapist is a social worker their code of ethics specifically say that they put their clients needs over everything. That includes what the board of social work says or any other legal entity. So protection of privacy and helping you go over almost everything.

First of all, I understand this concern and empathise. I am a very private person and also have a high level of distrust for centralised systems and beaurocracy.

It depends on how much you trust your therapist. You could ask them not to transcribe the portion of your session where you talk about politics. Also, it’s possible that the notes your therapist makes will not contain specific details of what you talk about, and instead be observations about what concerns you, and why you feel concerned.

At the very least, I would suggest asking your therapist the same question you’ve asked here: how can you be open and honest when you have these concerns? Your therapist may be able to address these concerns to your satisfaction. And if you don’t feel comfortable or safe asking your therapist this, then this might be a sign that your therapist hasn’t earned your trust (yet).