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Mackenzie Dunham



You don’t have to be a person who identifies as LGBTQQIA+ for me to work with you. You also don’t have to be a child or young person. I love what I do, and I’m glad to meet with people of all walks of life. In addition to my specialization, I was trained to be an advanced generalist, which means I can hang with just about whatever you throw out at me. If I don’t think I can help, or if I know another clinician in the community that I trust and think would be a better fit for you, I’ll tell you. The quality of the therapeutic relationship is the number one predictor of a good outcome for you, and I don’t want to waste either of our time.

My favorite style of this work is group. I’m pretty confident that when most people think of group they picture a bunch of stranger in folding chairs awkwardly sharing and simultaneously trying to figure out any reason to leave. That’s the movie version, and it has never been my experience. To me group has always been this sacred process where I’ve seen the most growth in people in the shortest amount of time. It is magic. Is group awkward? Yep. But isn’t everything when you aren’t used to it? In my experience, by the time you’re done with the first one most people are excited to continue. Is group scary? Only before you start, and the first 15 minutes. Will you cry in front of other people? That kind of depends on if you want to. All the research has my back on this - group works. It is the most effective form of therapy. It fosters connection, reduces feelings of loneliness, increases your ability to relate to humanity, and encourages self-compassion. In every one of the groups I’ve done, we reach a place (rather early on) where at the end of the session people don’t want to leave. They linger about in my office talking and visiting and I eventually have to heard them out. I love it. It is a wonderful problem to have.

All of the groups I run these days are based on a curriculum. I’m certified to facilitate the following curricula: Daring Greatly™, Rising Strong™, BOLD™, The Gifts of Imperfection™ (all of which are based on the research of Brene Brown); I am also certified to provide The Incredible Years, Circle of Security, Triple P, and Attachment Vitamins (all of which are based on the research and principles of positive parenting, and attachment theory).

In individual sessions, I pull from all of these curricula, as well as other clinical training I’ve had.

I cut my teeth in the world of addiction treatment. I’ve worked in suicide prevention, treatment centers, jail, a pediatric clinic, a group practice and at Children’s Home Society of Washington, where I first met Justin. I have a Bachelor of Science in Psychology from Washington State University (2008), and a Master of Social Work from Eastern Washington University (2012).



From the horse’s mouth, here is how my clients describe me:

“I would like to say thank you for the support and guidance that she is giving both myself and my kiddo. The group atmosphere has brought my awareness to a whole new level and has given me the tools to support my kiddo.”

“This human is amazing!”

“We can't thank Mackenzie enough for all that she has done for our family. She has been such a bright spot and a safe space for not only me as a parent, woman and human being but she's also been an invaluable resource and safe space for both of my children. I can't recommend her highly enough and am so grateful that her compassionate heart and open mind are a part of our lives. Thank you Mackenzie.”

“I've had a few therapists before but no one has helped as much and as quickly as Mackenzie has. She's helped restored my faith that people actually will listen, trust that I know what I'm dealing with, and know just how to provide help and understanding.”

“I have so appreciated being able to have her as my counselor. Out of any counselor I’ve seen, she’s the only one I’ve made real progress with. The difference is amazing and I know I wouldn’t be where I am today without her guidance.”


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The Daring Way™

The Daring Way™ is a highly experiential methodology based on the research of Dr. Brené Brown. The method was designed for work with individuals, couples, families, work teams, and organizational leaders. It can be facilitated in clinical, educational, and professional settings. During the process facilitators explore topics such as vulnerability, courage, shame, and worthiness. Participants are invited to examine the thoughts, emotions, and behaviors that are holding them back and identify the new choices and practices that will move them toward more authentic and wholehearted living.

Daring Greatly™

Based on the best selling book, the Daring Greatly curriculum’s primary focus is on developing shame resilience skills and developing daily practices that transform the way we live, love, parent, and lead.

Rising Strong™

The physics of vulnerability is simple: If we are brave enough, often enough, we will fall. Rising Strong is a book about what it takes to get back up and how owning our stories of struggle gives us the power to write a daring new ending. Struggle can be our greatest call to courage and the clearest path to a wholehearted life.


Specifically redesigned for adolescents, and younger adults, BOLD brings together elements of Daring Greatly, and Rising strong to help young people to live brave, be original, live big, and dare greatly.




Caring for Transgender Children and Youth

Affirming Mental health Care

I provide affirming mental health care, which means that whatever gender you identify with or whoever you’re attracted to - I’m not going to try to change that. I’m going to affirm it. I’ll do this by using your name and pronouns, by not making it a big thing, or telling you that you’ll have to be patient with me to adjust to it. Our forms and records are also set up to reflect the name you go by, even if it isn’t your legal name. There is one and only one place we need your legal name and that is on insurance claims. Other than that, given/birth/dead names won’t even be seen. Unless you identify situations that it is not okay to use your name, and need us to call you something else, I won’t. And if you change your name or pronouns, that’s okay too.

Caring for the Whole Family

When I work with transgender youth, it is a rare thing for me to only be in contact with the youth. Most times, I find myself sitting with parents too, sometimes with my client (their child), and sometimes just them on their own. I have a deep love for parents and try my best to meet them wherever they are at. I’ve worked with parents who are totally on board with their child’s gender identity, parents who are trying to be supportive but are also very confused, and parents who for a variety of reasons believe that what their child is experiencing is not okay in any way. My goal when I work with families is to hold space for whatever their emotional need is, and help them reckon with the idea that they are going through something different than their child. Suicide rates for transgender youth are terrifying, but supportive family cuts them in half. I have yet to meet a family that did not want their child to live a happy and healthy life. That’s what their child wants too. It is what I’ll work toward with your family.


Hormone Readiness Assessment

I often get asked if I write letters for hormones. Adults should be able to just go to the doctor without a letter. For medical minors, my practice is much more thorough than a letter. I write a comprehensive psychosocial assessment that encompasses an individual’s gender narrative, and their experiences and understanding of gender as a construct. Each report uses a battery of screening tools to help me get a clear picture of what my clients are experiencing in terms of dysphoria and mental health symptoms. I interview the young person independently, their parents independently, and then everyone together. I make recommendations based on my clinical assessment of mental health symptoms, the family’s understanding of medical procedure and the ability to make informed consent. My goal by the time we’re done is that everyone is on the same page with next steps. I do not consider myself to be a gatekeeper but I do recognize that my position is one of authority. I consider myself apart of the medical team that is helping clarify complex issues, and provide a clear and concise summary to endocrinologists so they are comfortable and confident moving forward with medical interventions. My process takes a minimum of four, sixty minute sessions. For some people, they want it to go faster, others ask me to drag it out. I go at a speed I’m comfortable with to be able to make clinical recommendations. When working with adolescents pursuing HRT, the best practice is for clinicians to move slower, rather than faster, especially if the client has not been in counseling, and there is no collaborative partner.

WPATH STandard of Care

I am a member of the World Professional Association of Transgender Healthcare, WPATH. WPATH is an interdisciplinary professional and educational organization devoted to transgender health. Their professional, supporting, and student members engage in clinical and academic research to develop evidence-based medicine and strive to promote a high quality of care for transsexual, transgender, and gender-nonconforming individuals internationally. WPATH publishes the Standards of Care and Ethical Guidelines, which articulate a professional consensus about the psychiatric, psychological, medical, and surgical management of gender dysphoria and help professionals understand the parameters within which they may offer assistance to those with these conditions.

I use the WPATH Standards of Care to guide how I work with transgender clients, and to help families understand what they can expect in terms of the effects of hormone therapy, as well as the risks.