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Background  Transgender women are at high risk of depression and suicidal ideation. The interpersonal theory of suicide proposes that suicidal ideation could be a consequence of high interpersonal needs (thwarted belongingness and perceived burdensomeness). The current study tests this theory and investigates whether depression could mediate the relationship between interpersonal needs and suicidal ideation among transgender women in Shenyang, China.    Methods  A total of 198 transgender women were recruited by snowball sampling. A cross-sectional study was conducted through a structured questionnaire. Suicidal ideation, depression, and interpersonal needs were assessed. Path analysis was used to carry out the research goals and the mediating effect of depression was tested.    Results  There were nearly 37% of the participants reported lifetime suicidal ideation. Suicidal ideation was positively correlated with thwarted belongingness ( t  = −5.53,  p  &amp;lt; 0.01) and perceived burdensomeness ( t  = −5.02,  p  &amp;lt; 0.01). The direct effect from thwarted belongingness to suicidal ideation  via  depression was statistically significant (Std. β = 0.232,  p  &amp;lt; 0.01). Depression could also mediate the indirect path from perceived burdensomeness to suicidal ideation through depression (Std. β = 0.222,  p  &amp;lt; 0.01) although the direct path between them was not significant (Std. β = 0.046,  p  = 0.693).    Conclusions  Depression fully mediated the relationship between perceived burdensomeness and suicidal ideation, and partially mediate the relationship between thwarted belongingness and suicidal ideation. To reduce the risk of suicidal ideation among transgender women, interventions targeting thwarted belongingness, perceived burdensomeness, and depression are needed.

The Mediating Effect of Depression on the Relation Between Interpersonal Needs and Suicidal Ideation Among Chinese Transgender Women