Sexual-Orientation OCD, Part 2

Sexual-Orientation OCD, formerly known commonly as HOCD, is a common subtype of Obsessive Compulsive Disorder focused on themes of sexual orientation and sexual attraction. While this disorder is has previously been referred to as “HOCD”, it does not always pertain to specifically “homosexual” themes, but can also include fears of bi-sexuality, pan-sexuality, and even fears of heterosexuality. Therefore, HOCD is also more broadly known as Sexual Orientation OCD (SO-OCD). Though it has many terms and definitions, SO-OCD is one of the most commonly experienced subtypes of OCD.

What is Obsessive Compulsive Disorder

OCD is marked by a pattern of unwanted and intrusive thoughts, feelings, mental images, physical sensations, and urges that are perceived as being inconsistent with the sufferer’s generally acknowledged character, interests, and values. While these internal emotional and mental experiences are typically related to anxiety, SO-OCD symptoms can also present as attraction, sexual arousal, uncertainty, questions about attraction, anger, and even neutrality or the absence of feeling. Regardless of what they are, they perceived as unwanted, incompatible with one’s true self, and in direct conflict with one’s existence.

In an attempt to get rid of these unwanted and unwelcome feelings and thoughts, the OCD sufferer will do compulsive acts, rituals, or avoidance. The feeling of uncertainty and fear are generally unwanted by the majority of people, and for those with OCD, this feeling can be overwhelming. Those with SO-OCD symptoms often try to seek reassurance that they are straight, avoid being around gay people or neighborhoods, and even trying to suppress any “gay-related” thoughts, just to name a few compulsions. While these compulsive behaviors can help return a sense of calm and emotional certainty, it is ultimately temporary and counter-productive.

Sexual-Orientation OCD and Masculinity

While SO-OCD obsessions are triggered independently by intrusive thoughts, mental images, and physical sensations, they can also be triggered by misinterpreted conclusions to one’s own interests and experiences, or lack thereof. Unfortunately, there exists a common Western-culture archetype of what it means to be a “man.” We all know the elements included here. A “man” is a guy who’s into sports, not into musical theater (or art in general), drinks beer, is outgoing, physically strong, and is dominant in the board room and the bed room. He probably drives a truck, too. Maybe with those “truck nuts,” if you know what I mean. Google it if you don’t.

This description doesn’t fit every man, and some men’s SO-OCD can be fueled by their divergence from this archetype. For example, their anxiety points out their lack of interest in sports, their interest in non-violent video games, and their timid or passive personal character to cast doubt on their masculinity, and subsequently their heterosexuality.

One’s heterosexuality has nothing to do with masculinity, and masculinity has nothing to do with aligning with an arbitrary, socially influenced, and outdated framework. Despite this, SO-OCD endeavors to draw a direct line between one’s interests and their sexuality. Men who experience this type of SO-OCD attack often struggle with reassurance seeking compulsions or avoidance. They will sometimes avoid their interests they fear are not masculine or could be considered feminine, or engage in reassurance seeking with friends and loved ones to check that they are still “OK.”

Treating issues of SO-OCD and masculinity in therapy includes breaking down one’s constricting and maladaptive interpretation of masculinity, reconsidering a personally meaningful definition of what it means to be a man, and building acceptance for one’s own unique character, interests, and values.

Sexual Orientation OCD and Homophobia

When SO-OCD is first experienced, sufferers can be caught off-guard by their intense reaction to homosexual thoughts or other gay related subjects. This strong response can make the sufferer question whether they have negative or antagonistic feelings toward the LGBTQ+ community or even the concept of being gay. In short, they can begin to question whether they are homophobic or if there is a connection between SO-OCD and homophobia. Spoiler, there isnt.

For many people, questions like this compound the distress experienced with SO-OCD as many SO-OCD sufferers identify themselves as LGBTQ+ allies and supporters. So, noticing their anxiety can lead them to a false conclusion based on incorrect assumptions. They may believe it follows that “supporters of gay people are comfortable with gay people and subjects, so feeling anxiety or anything other than support means I am homophobic.” This strikes at the person’s sense of moral character and can trigger compulsive ruminations about one’s feelings about or around gay people.

Similarly, some can experience obsessions motivated by their supportive position for the LGBTQ+ community. OCD makes claims that their support for the gay community is not rooted purely in benevolence and altruism, but is a reflection of their deep-down, and potentially suppressed, true gay sexual orientation. While OCD can be convincing in its rhetoric and argument, this fear is yet another way that OCD concocts elaborate and absurd stories based on a sliver of information.

SO-OCD is a master at redirection and urgency. In these examples, OCD presents the sufferer with feared stories that feel like they must be addressed, fought, and defeated in order to maintain a stable and certain sense of self. Conversely, these stories do not deserve any further attention or analysis than has already been done. In fact, rather than attempting to determine exactly what percentage of the obsession is based on fact and which parts are the OCD lie, the sufferer should instead recognize that not all the thoughts we have are important. Accepting thoughts, especially those that feel so far from our typical beliefs and values, is vital when working to devalue the role of OCD and compulsive behaviors.   

For more information about SO-OCD, to discuss SO-OCD teletherapy or in-office treatment at the Fullerton, Orange County location, or to schedule an assessment and begin treatment, please contact me.