Affective dysregulation, familial psychopathology, and suicidal behavior in transgender individuals: A structural equation model

Abstract

Background: Transgender individuals present disproportionately high rates of suicidal behavior, yet little is known about the affective and familial mechanisms that explain this vulnerability. This study examined an explanatory model of suicidal behavior grounded in affective dysregulation, impulsive aggression, and familial psychopathology. Methods: A clinical sample of 506 transgender individuals attending a gender identity unit in Spain completed structured assessments of mood disorders, impulsive aggression, exposure to violence, childhood abuse, and suicidal behaviors. Structural equation modeling (SEM) using maximum likelihood estimation was applied to test direct and indirect pathways linking familial and affective variables to suicide attempts. Results: The final model demonstrated excellent fit (χ2 /df = 1.692, GFI = 0.955, IFI = 0.956, RMSEA = 0.037) and explained 48% of the variance in suicide attempts. Affective dysregulation (β = 0.520, p < .001), impulsive aggression (β = 0.173, p = .015), and environmental adversity (β = 0.420, p < .001) were significant predictors of suicidal behavior. Parental mood disorders exerted indirect effects on suicide attempts through their influence on offspring mood disturbances. Limitations: The cross-sectional design precludes causal inference. Mood disorder diagnoses relied on clinical interviews rather than standardized diagnostic instruments. The wide age range may limit generalizability to adolescent-specific samples. Conclusions: Findings indicate that suicidal behavior in transgender individuals arises from interrelated affective, familial, and environmental mechanisms. Early detection of mood disturbances, assessment of impulsive aggression, and family-based interventions may help reduce suicide vulnerability in this population.