Introduction: Hemophilia A and B, which are characterized by the deficiency of blood clotting factors VIII and IX, progress with bleeding and related complications. In our study, we aimed to investigate the emotional state and appearance anxiety of these patients and the emotional state of their spouses who are responsible for their care. Materyal method: We included 44 adult patients (age 18–57) with severe hemophilia A or B and 28 spouses. Psychological assessments were performed using the Beck Depression Inventory (BDI), Social Appearance Anxiety Scale (SAAS), and Oxford Happiness Questionnaire (OHQ). Cutoff values were applied: BDI >20 indicates depression; SAAS higher scores reflect greater anxiety; OHQ scores >140 indicate high happiness, 100–139 moderate, and <100 low happiness. Correlation analyses between annual bleeding frequency and psychological outcomes were conducted using Spearman’s rho. Results: Patients had a mean BDI score of 23.7 (depression range), mean SAAS score of 42, and spouses had a mean BDI score of 21.6 (depression range) with OHQ mean of 120 (moderate happiness). Annual bleeding frequency was positively correlated with patient BDI (r=0.662, p<0.001) and SAAS (r=0.480, p=0.001), and negatively correlated with spouse OHQ (r=-0.435, p=0.018). Discussion: Bleeding complications significantly affect patients’ emotional state and appearance anxiety, and in our cohort appearance anxiety was negatively correlated with age; however, subgroup analyses were not performed. Spouses also experience reduced happiness. These findings highlight hemophilia as a family-wide burden requiring integrated psychosocial support. Future longitudinal and interventional studies are needed to confirm these findings and guide comprehensive care models.