Transgender women have a high prevalence of suicidal ideation, with stress and low interpersonal needs as its main risk factors. This study aimed to investigate the mediating role of interpersonal needs on the relationship between perceived stress and suicidal ideation among transgender women in China.A cross-sectional study was conducted in Shenyang and Kunming from April to September 2018. 247 transgender women were recruited. Sociodemographic statistics, perceived stress, interpersonal needs and suicidal ideation were obtained. Correlation analysis and mediation analysis were performed to test the relationship among perceived stress, suicidal ideation and interpersonal needs.14.6 % of the participants reported suicidal ideation within a year. Perceived stress was positively correlated with suicidal ideation (r = 0.228, p < 0.001), interpersonal needs and its three dimensions (r = 0.300-0.583, ps < 0.001)-thwarted belongingness, perceived burdensomeness and social exclusion. Interpersonal needs and its three dimensions were also positively correlated with suicidal ideation (r = 0.148-0.299, ps < 0.05). Interpersonal needs, perceived burdensomeness and social exclusion partly mediated the relationship between perceived stress and suicidal ideation, while thwarted belongingness didn't play a mediating role.Cross-sectional study limited confirmation of causality between variables. The investigation didn't aim at the specific stressors of sexual minorities. And that participants came from only two regions might affect the generalization of the results.We found a partial mediating role of interpersonal needs between stress and suicidal ideation. Stress reduction and increased social inclusion are needed to reduce suicidal ideation in transgender women.Copyright © 2024. Published by Elsevier B.V.