It’s completely normal to question your sexuality—many people do at some point in their lives. However, if you find yourself constantly obsessing over your sexuality, experiencing recurrent intrusive thoughts, and having intense anxiety, it could be a sign of a mental health condition. Excessive fears about your sexuality align with a common subtype of obsessive-compulsive disorder (OCD) known as sexual orientation OCD (SO-OCD).
SO-OCD is much different from genuinely exploring your sexuality and reflecting on who you are attracted to. With OCD, the brain seeks 100% certainty about who you’re attracted to—something that’s very unlikely to attain.
Keep reading to learn more about how SO-OCD differs from healthy self-exploration and how to find the right support.
What is sexual orientation OCD?
SO-OCD is a subtype of obsessive-compulsive disorder focused on concerns about your sexual orientation. OCD is characterized by a cycle of obsessions and compulsions. Obsessions are repeated, unwanted intrusive thoughts, sensations, images, or feelings, and compulsions are repetitive behaviors or mental acts performed to neutralize the obsession, or to prevent something bad from happening. However, the relief is only temporary, so the cycle of OCD continues.
SO-OCD can cause an overwhelming need to be certain of who you’re attracted to. This does not mean that you’re afraid of being attracted to people who have the same or different gender, but rather that you are afraid of the uncertainty you feel about your own identity and desires.
Below are some examples of common themes in SO-OCD:
- A straight person obsesses over the possibility that they may be attracted to someone of the same gender, although they don’t have any desire to act on it.
- A queer person experiencing intrusive doubts about whether their attraction to a certain person means that they’re “not really queer.”
If you’re in a relationship, you may feel guilty even having these thoughts because you think they make you disloyal, even though that’s far from the truth. Or they may make you feel like you’re wasting your partner’s time because you’re not totally certain of your sexuality. You may also feel ashamed for being bothered by these thoughts, out of fear that they could be seen as intolerant of different sexual orientations.
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Signs of SO-OCD
People with SO-OCD may experience intrusive thoughts and engage in compulsive behaviors to find certainty about their sexual identity.
Common obsessions in SO-OCD:
- “Am I actually (gay/straight/bisexual/asexual/etc.)?”
- “Have I just been pretending or lying about my sexuality the whole time?”
- “What if I’m straight even though I’ve only ever felt attracted to the same sex?”
- “What if I’m actually bisexual but I don’t know it?”
- “I felt a physical response when looking at that attractive person. Does that mean I’m into them?”
- “What will happen if my sexuality remains confusing or fluid?”
SO-OCD obsessions lead to compulsions, which can be both physical and mental. Physical compulsions are things we can see, like actively avoiding triggering situations. Mental compulsions can’t be seen, but are just as distressing. These can include mentally reviewing situations to see how you feel around various genders, or looking for clues of sexual attraction.
Common compulsions in SO-OCD:
- Avoiding dating.
- Asking for reassurance from others.
- Checking an outfit to make sure it conforms with society’s expectations of your sexual identity.
- Repeatedly taking “Am I gay/straight/bisexual/etc.?” quizzes.
- Trying to prove doubts wrong by internally checking and recalling your sex and dating history.
- Checking your body for arousal or physical sensations.
- Mental rumination over encounters, including “rewinding the tape” on memories to check your behavior or feelings at the time.
Know the difference: SO-OCD vs. genuinely questioning your sexuality
With OCD, questions and doubts that pop up out of nowhere—or in response to specific triggers—cause significant distress. If you’re exploring your sexuality, you may indeed struggle with anxiety and other intense feelings as you navigate this period—especially as you begin to assess your comfort level with dating or disclosing your sexuality publicly. But when OCD isn’t present, these concerns are much less repetitive and time-consuming.
The difference with OCD is that the endless doubts feed a feeling that any questions about your sexual orientation must be immediately solved with one hundred percent certainty, says Tracie Ibrahim, MA, LMFT, CST, Chief Compliance Officer at NOCD. “When people are sorting out their sexual attraction, it presents differently than OCD, and it is something a trained OCD specialist can assess,” she adds.
Someone with SO-OCD is not necessarily afraid of having one sexual orientation or another; rather, it’s their inability to feel sure of their own sexuality and identity that causes significant distress. For example, SO-OCD can lead you to overanalyze unwanted physical sensations you experience in response to different genders, and interpret this sensation to be a “sign” that you are actually in denial of your sexuality.
Seeking certainty, like with all types of OCD, will lead you to avoid triggers or accommodate their lifestyle because they feel unable to tolerate not knowing the answers to the questions posed by their OCD. You can never be 100% certain of anything because there is always an opportunity for a “what if” thought to sneak in there.
What to do if you have SO-OCD
All forms of OCD, including SO-OCD, are highly treatable with a form of cognitive-behavioral therapy known as exposure and response prevention (ERP) therapy.
During ERP, your therapist will lead you in identifying and gradually confronting your obsessions, while also guiding you as you resist engaging in compulsions. These techniques will help you stop trying to find one true “answer” about your sexuality, and instead be able to sit with any uncertainty that exists.
“The key is to stop trying so desperately to solve SO-OCD by using non-engagement responses,” Ibrahim says. “They help you disengage from the intrusive doubts and allow your focus to move on to the things you need to get done, such as school, work, or other activities.”
Exposure exercises that your therapist might try include:
- Writing out a script in which you identify as a different sexual orientation, like a story of how your day would look if you were straight instead of gay.
- Watching videos of people of varying sexualities.
- Wearing clothing that stereotypically is associated with a different sexual orientation.
ERP helps you learn that you are capable of tolerating anxiety, discomfort, and uncertainty, and that the uncomfortable feelings that arise from intrusive thoughts will dissipate with time. Engaging in ERP can allow you to live your life instead of constantly ruminating over the uncertainty of your sexuality.
If you’re unsure whether you’re experiencing SO-OCD or simply exploring your sexuality, there are several OCD specialists—some within or affirming of the LGBTQIA+ community—who can help you better understand what you’re going through and guide you toward the right treatment and support.
Although it can be helpful to have a therapist who specializes in SO-OCD, any clinician who has received training in OCD and ERP can help you manage your symptoms and find lasting relief.
Bottom line
Questioning your sexuality is a normal and healthy part of self-discovery that many people go through at some point in their lives. What sets SO-OCD apart are the intrusive thoughts and anxiety, followed by compulsive behaviors that aim to get absolute certainty about your sexuality. If you’re ready to escape the cycle and regain control of your life, reach out to an OCD specialist to take the first step towards recovery.
Key takeaways
- Sexual orientation OCD (SO-OCD) is a subtype of OCD that involves intrusive doubts and compulsions focused on your sexual identity.
- Unlike genuine self-exploration, SO-OCD is driven by anxiety and a need for 100% certainty about your sexuality.
- SO-OCD is highly treatable with exposure and response prevention (ERP) therapy, which helps you tolerate uncertainty and stop the cycle of obsessive rumination.