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Specializing in the Treatment of Sexual Orientation OCD (SO-OCD) and other Sexual Orientation Conditions

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Sexual Orientation OCD (SO-OCD)

Sexual Orientation OCD is sometimes referred to as HOCD, an abbreviation for Homosexual Obsessive-Compulsive Disorder. This is an unfortunate abbreviation because it misses the true nature of this manifestation of OCD.

First of all, it’s not exclusive for individuals who are straight. Many homosexuals, both male and female, who suffer from obsessive worries of being “straight” and who suffer equally when OCD challenges their sexual identity have been treated by the therapists at the OCD Center of Los Angeles throughout the years. Moreover, clients with this condition describe worries that are not really related to being gay (or straight). Fundamentally, OCD related to sexual orientation is the fear of not knowing for sure and the fear of never being HOCD treatmentable to have a loving, healthy relationship with someone to whom they are genuinely attracted to.

In a similar vein, a person who fears contamination may seem excessively preoccupied with dirt, yet this worry is a sign of an overwhelming fear of never feeling clean again. “If I don’t wash my hands, I will feel this way forever and nothing will be right in the world.” For every cry of “does this mean I’m gay?” there appears to be a louder cry of “does this mean I can’t be heterosexual anymore?”

In our experience with these clients, it also appears to have little to do with homophobia or bigotry. On the contrary, these clients are often quite open-minded on issues related to sexual orientation. In fact, it is their own lack of bigotry that often ends up being a fear trigger. One notable exception is cultural bigotry in which part of their Sexual Orientation OCD is fueled by the broader societal beliefs of the sufferer’s culture of origin. For simplicity’s sake, we will refer to “gay” throughout the rest of this article to describe any sexual orientation that is not one’s own. For those who are homosexual but have obsessive fears of “straightness” please substitute the appropriate word.

One thing that has struck us as bizarrely consistent is that OCD sufferers who obsess about their sexual identity seem notably less “gay” than me. Allow me to illustrate:

  • Picture a man who loves the arts, has no interest in sports, admires electronic music, doesn’t “pull chicks” at the bar and feels little discomfort in the presence of naked men in the gym locker room. Obviously gay, right? But then, that describes me, despite the fact that I am straight.
  • So, what is the opposite of me? A man who loves watching sweaty guys fight over a ball, admires music fronted by long-haired androgynous men singing about love, and showers at home to avoid naked guys… Well, this sounds pretty gay too.
Click here to take our free and confidential SO-OCD test.

So, this is what happens when your OCD locks in on sexual orientation. Whoever you are, whatever you do, suddenly seems gay. Just as the selective abstraction found in Contamination OCD makes it appear that dirt is everywhere, so does this same distortion make gayness appear to be hunting you down.

Those who suffer from this type of OCD are prone to over-analyze any hint that their “sexual orientation of origin” might be “compromised.” This frequently turns into a significant trigger as sexual experiences are likely to be less satisfying due to anxiety, distraction, and a lack of being “in the moment.” “I must be homosexual (or bi, or trans, or asexual, or…) if I do not always want straight sex!” And the idea that their libido is actually compromised as a result of the anxiety and obsessions that they experience due to their OCD just sounds like an excuse, or even outright denial, rather than a rational argument. You simply cannot win when you play OCD’s game – OCD cheats.

Many people who suffer from Sexual Orientation OCD get stuck on the notion that they may or may not find someone attractive and that this may or may not mean something important about them sexually. If they see a member of the same sex, they feel it is possible that the “seeing” was really intentional “looking” and that this intentional looking indicates a secret sexual desire. They will often then attend to and monitor their genitalia to check for arousal in an attempt to prove or disprove the theory. This often backfires since attention causes sensation. This, by the way, is true of other body parts as well. When you consider picking something up with your hands, the brain actually sends a priming impulse to the hand before you’ve even made a decision to move.

It is important to recognize the fundamental error in the line of thinking that equates recognition of attractiveness with sexual desire. Attraction is a word we use to describe the feeling of being drawn into something, like a magnet. We typically conceptualize this feeling of being pulled-in as proof of our desire to be near someone or something. For OCD sufferers who have a strong need for certainty on the nature of attraction, this idea is worrisome, especially when it is assumed incorrectly that all attraction is sexual.

Click here to read “HOCD: 30 Things You Need To Know”

I often hear the question, “Am I attracted to this person?” from my clients. It’s a loaded question, and I’m never exactly sure how to respond. Only whether the identified object is something they feel obligated to be close to is asked by the words themselves. Furthermore, any number of factors, both positive and negative, could be the cause of the attraction. However, my clients are typically inferring something more along the lines of, “Do I want to have sex with this person?” The notion that I might possibly know what someone else truly desires indicates an error in information processing. More startlingly, their OCD prevents them from considering the possibility that they might be attracted to someone while also preventing them from wanting to have sex with that person.

Every person is capable of identifying others as “attractive.” This means that a person, regardless of gender, meets some set of criteria that is personally and culturally seen as attractive. For Westerners, this may have something to do with musculature, bone structure, and/or facial symmetry. But according to researchers, ancient Mayans apparently had a cultural preference for those who were cross-eyed and had flat foreheads. In other words, “attractive” is not a fixed concept, and has different meaning for different people.

When we look at an attractive landscape in nature, we desire to be near it. When we see an attractive person, this also compels us to linger. In some cases, it may be envy that draws us in. Saying, for example, “I wish I had a body like that.” But in many cases, it’s just giving a thumbs-up to the universe. “Good one, Universe, you made an attractive person.” But for the person suffering with Sexual Orientation OCD, this triggers abject horror.

I often get asked the question, “Do you think I’m gay?” After the usual therapist-speak of “Does my opinion matter? Why do you want to know? And what would it mean to you if I thought you were?”, I suggest that my clients study the evidence with me. The test is not very thorough. It has one, simple question, with a few optional follow-ups:

“Do you like to have gay sex?”

That’s pretty much all we need to know in order to determine whether or not we should get busy with the work of treating their OCD.

We have seen clients with OCD who also happen to be gay. They obsess about the same things that other OCD sufferers struggle with, except quite notably that they don’t obsess about their sexual orientation. The only exceptions to this are gay clients who obsess about the possibility that they might actually be straight. And I have never had a homosexual client tell me they weren’t sure if they liked homosexual sex.

On the other hand, for straight individuals with Sexual Orientation OCD, their biggest fear is often that they will seek therapy for unwanted thoughts about their sexual orientation, and that the therapist will tell them that these thoughts indicate that they must actually be gay. Unfortunately, this often happens when clients end up with ill-informed treatment providers who don’t understand what constitutes Obsessive Compulsive Disorder and illuminates the importance of finding a therapist who thoroughly understands OCD and its appropriate treatment with Cognitive Behavioral Therapy (CBT).

To put it as simply as possible, gay thoughts are not unwanted by homosexuals. For homosexuals, gay thoughts are what psychologists call ego-syntonic thoughts. That’s just a fancy way of saying that their gay thoughts are in keeping with their true values and desires. Conversely, for heterosexuals, gay thoughts are ego-dystonic, which simply means that the thoughts are in opposition to their true values and beliefs. Furthermore, gay people like to have gay sex, while straight people with Sexual Orientation OCD are terrified of having gay sex.

Click here to email the OCD Center or call us at 310 824-5200
Click here to take our free and confidential HOCD test
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