Sexual-Orientation OCD, Part 2

This article is part two and a continuation of a previously published article about HOCD symptoms and HOCD treatment. Click here to read part one. This article will deal with issues of HOCD and Masculinity, and HOCD and Homophobia.

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.

HOCD, Sexual Orientation OCD, Obsessive Compulsive Disorder, Homophobia, Am I gay

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.

Man lifting weights looking at his arm. Some men with Sexual Orientation OCD will have doubts about their sexuality if they do not fit the mold of the stereotypical "masculine guy." And just the same with women and femininity. However, this does not define your sexuality.
Stereotypical masculinity does not define your sexuality.

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.

Man wearing a shirt denouncing homophobia. Being supportive of the LGBTQ+ community does not make you gay, no matter what HOCD says.

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.

The California OCD and Anxiety Treatment Center offers specialized therapy for SO-OCD (Sexual Orientation OCD) in its Fullerton offices. In addition to serving North Orange County, Los Angeles, and the Inland Empire, CalOCD offers online therapy, group therapy, and Intensive Out-Patient treatment.


6 thoughts on “Sexual-Orientation OCD, Part 2”

    • HI Shawn,

      Yes. One very common symptom for people with HOCD (SO-OCD) is the obsession that they are looking at a same sex person and analyzing whether they are just looking at them in a sexual way or not. Often this is paired with comparing way it feels to look at a man vs looking at a woman to see if one feels “better” or “right” than the other. All of this should be resisted as much as possible.

  • Hi! I don’t trust therapy especially ERP. I don’t think I would have any control whatsoever. I think it’s brainwashing men into being gay. Maybe it supposedly works but I wouldn’t want it. It’s really more of the therapist’s agenda than my best interest at heart. I would be lied to or steered wrong. Please prove me wrong. Thanks!

    • Hi Darin,

      The purpose of treatment for all OCD subtypes, including Sexual Orientation OCD (formally HOCD), is to live a more fulfilling and personally meaningful life despite doubt, uncertainty, and anxiety. Furthermore, a good therapist works extensively to put their own wishes and desires at the door in order to help the client learn effective tools to manage anxiety and thrive despite unwanted, intrusive thoughts of any strip. ERP is incredibly helpful with this, however it is not the only effective treatment approach.

      For those turned off by ERP, Acceptance and Commitment Therapy can be a very effective alternative. There is absolutely no focus to “turn” anyone in any direction other than toward their fear so they can learn to overcome the anxiety and live a more meaningful life without unnecessary and life-draining compulsive behaviors.

      Lastly, therapy is a slow, patient, and cautious process that takes great pains to account for the client’s emotional needs in order to build trust and respect. Therapy is not about being bamboozled or thrown into the deep-end of the pool without your consent. Instead, it is a place to build self-confidence and regain your freedom from emotional and mental blocks in the way of the life you want to be living. I’m happy to discuss this further if you would like. Feel free to reach out at 714-423-3779, or email me at kevin@calocd.com.

      Thanks again!

  • I don’t want to self diagnose myself but i think i have HOCD. I’m scared that i am a lesbian and i just don’t know it yet when all my life I’ve been attracted to males. I’m scared and uncomfortable right now but i don’t feel any anxiety. I’ve had anxiety when i first started thinking about this thing but now i don’t feel anything yet i’m still doubting myself. I don’t know what to do. Do i have HOCD or am i just faking it?

    • Hi Daria,

      Many people report anxiety when triggered by an obsession or obsessive doubt, however others can report a whole host of other emotional responses, such as sadness, anger, neutrality, numbness, or emptiness. In response to these doubts, rumination compulsions can further blur the lines of what is known about yourself and what one fears could be true, leaving someone feeling confused, lost, and fearful.

      While I can’t diagnose you with SO-OCD (HOCD) here, I would encourage you to reach out to a therapist to discuss treatment or assessment options. You could also consider a consultation with an OCD professional in order to discuss your situation and experience and see what they would recommend. The internet can be a great place to find information, but it isn’t that great at addressing your individual needs and circumstances.

      Thanks again for the comment!

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