Fear of Negative Evaluation as a Mediator Between Emotional Expressivity, Self-Compassion, and Suicidal Ideation in People with Gender Dysphoria

Objective: This study aimed to examine whether fear of negative evaluation mediates the relationship between emotional expressivity and self-compassion with suicidal ideation in individuals diagnosed with gender dysphoria. Methods and Materials: A cross-sectional study was conducted using structural equation modeling (SEM). A total of 267 participants diagnosed with gender dysphoria in Tehran were selected via convenience sampling. Participants completed four validated instruments: the Beck Suicide Ideation Scale (BSSI), Emotional Expressivity Questionnaire (EEQ), Self-Compassion Scale (SCS), and the Brief Fear of Negative Evaluation Scale (BFNES-B). Data analysis was performed using SPSS 26 and AMOS 23. Bootstrapping techniques were employed to test indirect effects. Findings: Emotional expressivity and self-compassion were both negatively associated with suicidal ideation (p<0.001). Fear of negative evaluation showed a positive direct effect on suicidal ideation (p<0.001) and mediated the relationships between both predictors and suicidal ideation. The final model demonstrated good fit indices (CFI = 0.94, RMSEA = 0.079). Conclusion: Findings suggest that individuals with gender dysphoria who struggle with emotional expression or self-compassion may be more vulnerable to suicidal ideation, partly due to increased fear of negative evaluation. Interventions aimed at reducing evaluative concerns and enhancing emotional openness and self-kindness may help mitigate suicide risk in this population.