Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fears about homosexuality

By Andrea Fine

Aug 30, 20226 minute read

Sexual Orientation OCD is a subtype of obsessive-compulsive disorder focused on one’s sexual orientation. People who experience homosexual OCD may experience obsessions surrounding the uncertainty of their attraction or potential attraction to people of their same gender. This does not mean that someone is afraid of being attracted to people of the same gender, but rather that they are afraid of the uncertainty they feel about their own identity and desires.

Sexual Orientation OCD involves fears about not knowing or being sure of one’s sexual orientation. There are different categories of Sexual Orientation OCD relating to different themes of sexuality and gender. In the past, some have used the term “Homosexual OCD” to refer to themes within Sexual Orientation OCD that involve doubts or intrusive thoughts about attraction to people of the same gender, contrary to one’s own identity. 

People who experience homosexual themes in Sexual Orientation OCD may experience obsessions surrounding the uncertainty of their attraction or potential attraction to people of their same gender. These thoughts are ego dystonic, meaning they do not align with the person’s actual identity. Because of these incongruent obsessions, people can experience anxiety, distress, or even guilt or shame. Since sexuality influences relationships with other people, guilt or shame can be related to uncertainty about the person’s loyalty or commitment to their partner. 

Guilt or shame can also be evident if the person experiencing Sexual Orientation OCD struggles to disclose their anxieties in personal relationships or even therapy, out of fear that they could be seen as intolerant of different sexual orientations. With Sexual Orientation OCD, we understand that is not the case. Homosexual OCD does not mean that someone is afraid of being attracted to people of the same gender, but rather that they are afraid of the uncertainty they feel about their own identity and desires. 

That is where the anxiety and discomfort comes from with this type of OCD. Intrusive thoughts and doubts about one’s sexual orientation can be highly distressing and disorienting, and obsessions and compulsions related to one’s core identity can be very hard to live with.

OCD fear of being gay – Common obsessions

  • Am I actually gay or bisexual?
  • Have I just been pretending or lying about my sexuality the whole time?
  • What if I’m gay even though I’ve only ever felt attracted to the opposite sex?
  • What if I’m staying with my boyfriend only because I’m a lesbian afraid of coming out?
  • What if I’m actually bisexual but I don’t know it because I’ve only ever been with men/women romantically?
  • I felt a physical response when looking at that attractive man/woman. Does that mean I’m gay?
  • What will happen if my sexuality remains confusing or fluid?

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Common triggers

People with Sexual Orientation OCD may be triggered by situations in which they are exposed to people of the same gender or people who identify as a member of the LGBTQ+ community. Other triggers could include situations where they are hyperaware of their engagement in a heterosexual relationship.

Triggers common for people with homosexual OCD fears include:

  • Using social media 
  • Seeing online videos/content from creators in the LGBTQ+ community
  • Seeing LGBTQ+ individuals or couples
  • Talking with LGBTQ+ individuals or couples
  • Using dating apps
  • Going on dates
  • Meeting new people
  • Going to the gym
  • Being with one’s partner
  • Planning a future with one’s partner
  • Exposure to sexual content
  • Engaging in sex or romance

How can I tell if it’s OCD fear of being gay, and not normal questioning of my sexual orientation?

In OCD, the questions and doubts that either pop up intrusively or in response to specific triggers cause significant distress for the person experiencing them. Someone exploring their sexuality may indeed struggle with anxiety and other intense feelings as they navigate their sexuality and begin to assess their comfort level with dating or disclosing their sexuality publicly. 

The anxiety that accompanies Sexual Orientation OCD is linked more closely with the uncertainty surrounding what one’s sexual orientation is. Someone with homosexual themes in Sexual Orientation OCD is not necessarily afraid of having one sexual orientation or another; rather, their inability to feel sure of their own sexuality and identity causes significant distress. Seeking certainty, like with all types of OCD, leads the individual to avoid triggers or accommodate their lifestyle because they feel unable to tolerate not knowing the answers to the questions posed by their OCD. 

Guilt or shame can pop up for someone with homosexual OCD if they are in a heterosexual relationship and feel responsible for potentially wasting their partner’s time or causing them grief if they come to the realization down the line they are in fact gay, lesbian, or queer. Someone with Sexual Orientation OCD could feel like they are “weird” for experiencing their thoughts and doubts, even though they feel confident that they are heterosexual. Homosexual themes in Sexual Orientation OCD can lead people to overanalyze unwanted physical sensations they experience in response to stimuli from the same gender, and interpreting this sensation to be a “sign” that they actually are in denial of their sexuality.

Common compulsions

When people with fear of being gay experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in compulsions, 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 to the individual. These can include mentally reviewing situations to see how someone might have felt around people of the same gender before, or looking for clues of sexual attraction to people of the same gender.

Compulsions performed mentally or physically by people with gay OCD fears include:

  • Avoiding dating
  • Asking for reassurance from others who know your identity
  • Avoidance of dating/spending time with a partner, sex, social settings, or social media
  • Checking an outfit to make sure it conforms with their 
  • Providing self with assurance, such as by trying to prove doubts wrong by checking and recalling one’s sex and dating history
  • Asking for reassurance about one’s sexual identity from trusted individuals
  • Checking one’s body for arousal or physical sensations
  • Mental rumination over different encounters with others, including “rewinding the tape” on memories to check behavior or feelings at the time

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How to treat fears about homosexuality in OCD

Homosexual OCD can be debilitating for people who struggle with them, but all forms of OCD are highly treatable. 

Exposure and response prevention (ERP) therapy is the gold-standard treatment for all types of OCD. In ERP your therapist will lead you in identifying and gradually confronting the triggers of your obsessions, while also guiding you as you resist engaging in compulsions. 

Practicing ERP allows you to learn that you are capable of tolerating anxiety, discomfort, and uncertainty, and that uncomfortable feelings arising from intrusive thoughts and uncertainty often dissipate with time. Engaging in ERP can allow you to live your life instead of living in the shadows of OCD and uncertainty about your sexual orientation. 

If you’re struggling with OCD, As an OCD specialist, I’ve used ERP to help many people regain their lives from OCD. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

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