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Sexual Orientation OCD

What is Sexual Orientation OCD?
Sexual Orientation OCD, also known as Gay OCD or Homosexual OCD (HOCD), is a condition in which an individual, straight or gay, obsessively doubts their sexual orientation. Obsessions about sexual orientation differ from an individual who is actually gay because the person with OCD does not generally feel attraction or sexual arousal to members of the same sex. The individual with sexual orientation OCD fears becoming gay or discovering that he or she was unknowingly gay all along.​


Symptoms of Sexual Orientation OCD

The obsessions in Sexual Orientation / HOCD take the form of worry about becoming or being gay, engaging in same-sex sexual behavior, and being ridiculed by others for being gay. Common symptoms in HOCD involve:

  • Avoidance of sexual orientation-related triggers such as gay people, gay films and TV shows and gay neighborhoods
  • Physical rituals designed to “prove” one’s sexuality such checking one’s genitals for signs of arousal, increased sexual activity in an effort to prove to one’s self that they are straight, or compulsive masturbation to straight pornography
  • Mental rituals aimed at forcing unwanted gay thoughts away such over-analysis of gay thoughts, trying to force straight thoughts into consciousness or mentally reviewing past sexual encounters, etc.


Sexual Orientation OCD is often characterized by excessive doubt. The individual may first experience sexual orientation fears when noticing that a member of the same sex is attractive. The individual then questions why they had the thought and mentally panics, leading to more questioning. These fears are more than just fleeting thoughts; they become powerful obsessions that keep coming back. In an effort to make the thoughts stop, the individual performs compulsions, which may present as checking for indications of physical arousal when around attractive members of the same sex.


Treatment of Sexual Orientation OCD
The goal of Cognitive Behavioral Therapy (CBT) for Sexual Orientation / HOCD is to teach you that you can manage the anxiety associated with obsessive thoughts about your sexual orientation without performing mental compulsions or rituals to “test” your sexuality. You will learn a type of CBT called Exposure and Response Prevention (ERP). Treatment will include education about OCD and how it is maintained, cognitive strategies that will help you respond differently to anxiety and intrusive thoughts, and behavioral strategies to help you delay and/or eliminate compulsive behaviors. ERP/CBT will help you face your anxiety and discomfort about having doubts about your sexual orientation and practice new ways of responding to anxiety. With practice and experience facing your discomfort, you will find yourself less disturbed by these doubts and more able to cope with anxiety and bothersome images.


People suffering from HOCD are encouraged to seek treatment from a mental health treatment provider that specializes in the treatment of HOCD.  OCD specialists are equipped and prepared to treat a wide array of OCD subtypes, including Sexual Orientation / HOCD . Like all types of OCD, HOCD can be treated with a combination of Cognitive Behavioral Therapy and Exposure and Response Prevention.  Contact Lauren Pellizzi to start treatment.