Sexual orientation OCD (SO-OCD) is a subtype of obsessive-compulsive disorder (OCD) that causes intrusive doubts and fears about sexual orientation. These thoughts are unwanted, distressing, and feel out of sync with your actual identity. People with SO-OCD may fear they are secretly gay, straight, bisexual, or another orientation—despite having no desire to change their orientation in real life. In a study of 409 people with OCD, 8% reported having sexual orientation obsessions.
As distressing as they might be, understand that these obsessions are not a reflection of your true self—they’re symptoms of OCD.
Keep reading to learn more about sexual orientation OCD, including symptoms, how it’s different from genuine exploration, and how you can seek help.
What about HOCD? Is it the same as SO-OCD?
Yes, HOCD (homosexual OCD) is an older term that refers to the same subtype of OCD, but it’s considered outdated and potentially misleading.
“The term ‘HOCD’ can be misleading because it implies that the fear is about being gay when, in reality, the core struggle in SO-OCD is an intolerance of uncertainty,” explains Nicholas Farrell, PhD, LP, Director of Clinical Development & Programming at NOCD. “People with SO-OCD aren’t necessarily afraid of a specific orientation—they’re afraid of not knowing for sure.”
Today, the term sexual orientation OCD (SO-OCD) is preferred because:
- It’s more inclusive of all sexual orientations, including fears of being straight, bisexual, or any orientation.
- It avoids pathologizing queer and trans communities.
- It reflects the broader reality that OCD can target any identity—not just straight or gay.
If you’ve heard of HOCD before or think you might have it, you’re in the right place. SO-OCD is the current term used by OCD specialists and researchers.
What does SO-OCD feel like?
People with SO-OCD often experience overwhelming fear, confusion, or shame about their sexual identity. These feelings are not just passing curiosities—they are intense and repetitive, driven by OCD’s need for certainty.
Here are a few examples of SO-OCD obsessions:
- What if I’m actually gay and I’ve been lying to myself?
- What if I lose attraction to my partner?
- What if I’m secretly attracted to everyone?
- What if I never know my true identity for sure?
These thoughts feel intrusive, unwanted, and persistent—often accompanied by a deep urge to “figure it out.”
Are SO-OCD thoughts different from questioning your sexuality?
Yes. People who are genuinely exploring their sexuality may feel curious or open-minded—even if it’s confusing. In SO-OCD, the experience is driven by fear, doubt, and a desperate need for certainty. Rather than curiosity, it feels like panic.
Someone questioning their sexuality may seek understanding. Someone with SO-OCD seeks relief from obsessive fear.
Common compulsions in SO-OCD
People with SO-OCD engage in physical or mental behaviors (compulsions) to try to reduce distress from obsessions (intrusive thoughts, images, urges, feelings, or sensations) or “prove” their true orientation. These behaviors are not driven by curiosity—they’re driven by fear and a desire for certainty.
While not a complete list, here are a few examples of SO-OCD compulsions:
- Mentally reviewing past relationships
- Looking at photos or videos to “test” reactions
- Asking others for reassurance (“Do you think I’m really straight?”)
- Avoiding people or situations that trigger doubt
- Checking for groinal responses or other bodily sensations
Compulsions may bring short-term relief, but they reinforce and intensify the OCD cycle and make symptoms worse over time.
Is SO-OCD the same as being closeted?
No. Being closeted means you’re aware of your sexual orientation but haven’t disclosed it. SO-OCD involves distressing intrusive thoughts that feel incongruent with your known identity. You don’t want these thoughts—you want them to stop.
The key difference lies between distress and desire. People who are closeted may feel afraid of being outed, but they aren’t tormented by intrusive doubts about who they are.
Is groinal response proof of attraction?
No. Groinal responses are common in many types of OCD and do not reflect true attraction. They are often a result of hyperfocus and anxiety—not desire. In SO-OCD, people may fixate on physical sensations in the groin or chest area as a way of “testing” their reactions. But this can become a compulsive cycle that intensifies fear rather than offering clarity.
Why SO-OCD is so distressing
SO-OCD targets one of the most personal parts of your identity. People often feel embarrassed, ashamed, or even afraid to talk about their symptoms. They may fear judgment or worry that discussing these thoughts will bring them to fruition.
How is SO-OCD treated?
The most effective treatment for SO-OCD is exposure and response prevention (ERP) therapy. ERP is a specialized form of cognitive behavioral therapy (CBT) proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms.
In ERP, you’ll gradually expose yourself to triggering thoughts, images, urges, feelings, or sensations—without engaging in compulsive behaviors like reassurance-seeking, checking, or avoidance. Over time, this helps reduce OCD’s strength and builds tolerance to uncertainty.
Many people also benefit from combining ERP therapy with the following treatments:
Severe, treatment-resistant SO-OCD may require more intensive treatments, such as:
- Intensive outpatient programs (IOPs)
- Partial hospital programs (PHPs)
- Residential treatment centers (RTCs)
- Transcranial magnetic stimulation (TMS)
- Deep brain stimulation (DBS)
- Gamma knife radiosurgery (GKRS)
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
A note on LGBTQIA+ identity and affirming care
Questioning sexual orientation is a valid part of the human experience. Not everyone who feels unsure is experiencing OCD. If you’re wondering whether you’re going through sexual orientation OCD or simply exploring your identity, you’re not alone—and you don’t have to figure it out by yourself.
There are OCD specialists, including therapists who are part of or affirming of the LGBTQIA+ community, who can help you better understand what you’re experiencing. With the right support, you can get clarity, reduce distress, and move toward a place of confidence and peace—whether that means managing OCD or embracing a new understanding of yourself.
When to seek help
If you feel tormented by thoughts about your sexual orientation and can’t find peace—even when you try to reassure yourself—it may be time to get help. OCD is a medical condition, not a character flaw. You’re not broken or alone, and effective, evidence-based treatment is available.
Bottom line
SO-OCD causes intense, unwanted doubts about your sexual orientation—not because you’re discovering your identity, but because your brain is demanding certainty. It’s not about curiosity or desire; it’s about fear. SO-OCD is a treatable form of OCD, and with the right therapy—especially ERP—you can stop doing compulsions, tolerate uncertainty, and reclaim your peace of mind.
Key takeaways
- SO-OCD is a subtype of OCD, not a reflection of your true sexual orientation. Intrusive doubts and the need for certainty drive it.
- Common compulsions include checking, reassurance-seeking, avoidance, and mental review—all attempts to “figure it out.”
- SO-OCD can look like questioning, but it feels different: more distress, less curiosity, and a constant need to “know for sure.”
- Treatments like ERP therapy help people break the OCD cycle and reduce distress.
