OCD subtypes
Sexual Orientation OCD/SO-OCD

Is SO-OCD (HOCD) Just Denial? The Truth About Sexual Orientation OCD

3 min read
Keara Valentine
By Keara Valentine
All types of OCD include obsessions and compulsions. Obsessions are unwanted and intrusive thoughts, feelings, urges and doubts, while compulsions are repetitive physical or mental actions performed in an attempt to relieve distress and anxiety

Questioning your sexual orientation is incredibly common, and it’s a thought anyone can have. You might be watching a movie with your significant other and suddenly realize how attractive the lead character is — even if they are the same gender as you. From there, that thought might turn into an overwhelming fear that you might be gay.

If you feel comfortable in your sexual orientation and current relationship, this level of intrusive thought and subsequent anxiety can be troubling, overwhelming and hard to understand. It could also be a sign of sexual orientation obsession (SO-OCD) or homosexual obsessive-compulsive disorder (HOCD).

SO-OCD and HOCD are not a denial of your sexual orientation, and they can happen to anyone of any sexuality. For example, if someone has been interested in partners of the same sex and they obsess about whether or not they’re actually attracted to the opposite sex, it could be SO-OCD or HOCD. The same is true the other way — if someone has only been interested in partners of the opposite sex and they obsess about the same sex. This is more frequent, and is why it’s commonly referred to as HOCD.

Am I denying my true sexuality?

In short, no, you are not denying your true sexuality if you have SO-OCD or HOCD. 

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Both manifestations are subtypes of obsessive-compulsive disorder (OCD), a common anxiety disorder characterized by recurring, unwanted obsessions including thoughts and ideas, and compulsions such as repetitive behaviors or mental acts. Most people have some level of intrusive thoughts, obsessions and even compulsions in their lives. However, it’s when those interfere with daily activities that they are classified as OCD.

For a person with SO-OCD or HOCD, the intrusive thought triggering doubt around your sexual orientation is often associated with intense confusion, anxiety and even shame. You might feel that you know your sexual orientation, and then suddenly you start thinking about the opposite orientation — thinking about it so much that you become obsessed. This turns into unwanted thoughts and fears that you’re losing your sexual identity or in denial of your attractions, as well as relationship issues and difficulty performing sexually.

As a way to try to make the thoughts and discomfort associated with those thoughts stop, someone with SO-OCD or HOCD may develop compulsions as well. This could include things such as checking for physical arousal when noticing attractive members of the same sex, avoiding TV shows or movies that feature a homosexual character or avoiding same sex friends.

How can I stop the obsessions?

Understandably, the thought of discussing your sexual concerns with a complete stranger may be uncomfortable. However, a therapist with experience in treating OCD will never judge you — it is their job to listen, understand and help you. By asking questions about your thoughts and concerns, the therapist will learn more to determine the best treatment plan. Often, the plan will include exposure and response prevention (ERP) therapy, which is often regarded as the gold standard of OCD treatment.

During ERP, your therapist will work with you to build a plan specific to your OCD to help you learn new ways to manage thoughts, feelings and responses to your obsessions. This could involve starting with the exposure of identifying same-sex indivduals who are attractive or watching movies featuring a LGBTQ storyline (if you typically like opposite-sex individuals). Through this exposure, your therapist will help you develop response prevention measures based on what you hope to accomplish with therapy. Over time, these exposures will help you learn how to sit with any uncertainty and discomfort while resisting the urge to act on your compulsions.

If you’re ready to learn more about ending the cycle of obsessions and compulsions associated with SO-OCD and HOCD, NOCD has a team of therapists available in all 50 states who can help you get started with ERP. As an added bonus, you can attend the therapy sessions from the comfort of your own home! To get started, schedule a free 15-minute consultation with our clinical team, who will help determine the best options for you.

Keara Valentine

Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.

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NOCD Therapists specialize in treating Sexual Orientation OCD/SO-OCD

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Taylor Newendorp

Taylor Newendorp

Licensed Therapist, MA

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Madina Alam

Madina Alam

Licensed Therapist, LCMHC

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Tamara Harrison

Tamara Harrison

Licensed Therapist, MA

I have personally struggled with OCD and know what it's like to feel controlled by intrusive thoughts and compulsions, and to also overcome it using the proper therapy. I’ve been a licensed therapist since 2017. I have an M.A. in Clinical Mental Health Counseling, and practice Exposure and Response Prevention (ERP) therapy. I know by experience how effective ERP is in treating OCD symptoms.

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