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Let's find yours

There is a path for everyone

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Trailhead's —

My name is Nathan. I am a trans and queer-identified person who is passionate about giving back to my community and making the world a safer space for non-normative identities.

I am a Registered Social Worker who practices between my two home provinces of Ontario and British Columbia providing counselling to adults and young adults with trans and gender-diverse identities and sexual orientations. I also counsel partner(s) and families looking to better support loved ones with these identities or folks interested in working with someone who understands their identity. Please note I do not work with youth or persons under 19. I take an integrated approach to my practice, pulling from a variety of modalities including DBT, CBT,  motivational interviewing, trauma-informed, somatic practices, short-term, solution-focused, strength-based, and client-centred counselling. My services are covered by most extended health plans.

My role as a counsellor is to work with you collaboratively to draw on your strengths, provide psychoeducation, and find adaptable solutions to help you lead a more fulfilling life. As a trans and queer-identified person I am intimately aware of the unique needs of our community and want to help you find a way forward to a healthy and fulfilling future. There is a path for everyone, let's find yours.

"I think I knew right then, but sometimes knowing comes in layers."

-Leslie Feinberg




Nathan's  —  

Education, Registration & Experience

I hold a Bachelor's Degree from Simon Fraser University in Gender, Sexuality and Women's Studies and a Master's Degree in Social Work from the University of Victoria. I am a Registered Social Worker in the provinces of Ontario and British Columbia. I have also completed the Gottman Method Couples Therapy Level 1, the Sexually Competent Therapist Training with Allura Sex Therapy Centre and CBT Essential Program and CBT for Anxiety with the Beck Institute. 

I come to this practice with over 10 years of experience in mental and health and addiction services, including various organizations in Vancouver's Downtown Eastside, The Kelty Mental Health Center at the BC Women and Children's Hospital, the Psychiatric Emergency Services at the Royal Jubilee Hospital, and the Catherine Assertive Community Treatment Team, Flexible Assertive Community Treatment Team - Dual Diagnosis, and the Family Information and Support Services at the Royal Mental Health Centre. I have also co-authored research with the Stigma and Resilience Among Vulnerable Youth Center at the University of British Columbia and regularly provide Gender Inclusivity Educational Workshops to healthcare workers, support workers and educators.

In addition to this work, I also have a background as a community activist. At Simon Fraser University I was the lead organizer of the Trans Inclusive Committee whose efforts cumulated in policy changes allowing students to utilize their 'preferred' names and gender markers on student identifications, as well as the creation of gender-inclusive washrooms on campus. I also delivered a TEDx talk on the topic of gender-inclusive washrooms which highlighted the limited narratives we allow trans people to tell and how we can move past that ideology.

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Trailhead's  —  


$150 per session

I offer individual counselling focused on identity and gender exploration, sexuality, coming-out, complex trauma, and mental health concerns such as depression, anxiety, and mood disorders. No matter how lost, confused, alone or scared you are, I get it. I have been there too, but there is a happy and healthy future for you. Let's get there together.

$170 per session

Being in relation to other people is one of our most basic human needs. As fulfilling as relationships can be, they can be equally as complex. I can work with you and your partner(s) to guide you to meet these challenges with compassion, and come to a better mutual understanding of each other.

$180 per session for 2 people
$350 per assessment

Having a loved one come out as queer or trans can be life-changing as it uproots your ideas of who they are, where their future lies, and what your relationship with them looks like. This is hard for you, too. I am here to provide space for you and your concerns and build understanding as you forge a path forward. There is a future for them and you can be a part of it.

There is a $10 fee for each additional person included in the session.

As a Registered Social Worker and a trans person who has personally experienced these systems, I can offer practical support with government documentation and healthcare navigation such as hormone readiness assessments, surgical assessments, name and gender marker documentation and referrals to community partners.

Each assessment includes up to two sessions, report writing and coordination with care providers. Additional sessions are available at our regular rate.

Sliding scale is available for all services
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Let's Talk

Nathan MacRae, MSW, RSW

t: 604.652.3732


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Trailhead's  —  


Trailhead Counselling operates virtually in both Ontario and British Columbia. Nathan is a Registered Social Worker in both provinces and his services are covered by most extended health plans.

At this time, no in-person appointments are available.

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