I think "attractive" can target different features, physical appearance is only one. Mine never said anything about my appearance and I don't wish for it even though I had sexual fantasies about him a few times. Of course it would be flattering to hear and I don't think I would find it disturbing, but not something I desire.

I also think that whether it's appropriate or not depends on context and patient. For example, with a client who has insecurities about their appearance and discusses this with T, I think it can be therapeutic. But with someone who has, for example, fears about other people potentially having inappropriate or unwanted sexual thoughts, it would probably be a mistake or disturbing.

Negative comments on appearance though or validating a client's negative self imagine I would say very inappropriate from a therapist.