Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fear of Sex: Is it OCD, Erotophobia, Genophobia, or something else?

Apr 14, 20236 minute read

Reviewed byPatrick McGrath, PhD

A fear of sex may present in many different diagnoses like OCD, Erotophobia or Genophobia, and even generalized anxiety. We will talk a bit about the difference between a fear of sex in OCD and how it presents in a Specific Phobia (Erotophobia/Genophobia). 

Fear of Sex and OCD

A fear of sex in OCD may involve fears directly related to sexual acts. A person experiencing this subtype may have shameful, embarrassing, repulsive, and taboo fears relating to sex. These fears may cause people with OCD to go to great lengths to avoid sex because they fear the thoughts, urges, or images they may have during the act of sex. 

Other manifestations of OCD can also affect a person’s sex life. For example, someone who is struggling with Harm or Contamination OCD may simply avoid sex because they don’t want to feel obsessive anxiety about contamination the whole time they are being intimate, or have intrusive thoughts about hurting their partner and feel that they can’t risk their fears coming true in any way. 

These fears may also characterize a Specific Phobia, such as Genophobia (involving a fear of sexual intercourse) or Erotophobia, which involves fears about sexual intimacy more generally. We’ll discuss the ways these fears can be distinguished from the obsessions that characterize OCD, and the various ways these conditions can interfere with people’s lives. 

Whether one’s fears about sex result from OCD, a Specific Phobia, or another condition, they can be treated effectively and there is hope for anyone to engage in sexual intimacy without being ruled by their fears.

Common obsessions

In OCD, one’s fears are the result of intrusive thoughts, images, feelings, or urges known as obsessions. Obsessions may occur when one is exposed to specific triggers, or they may occur entirely unexpectedly. 

Common obsessions experienced by people with a fear of sex include:

  • Intrusive and repulsive sexual images, whether during sexual situations or otherwise
  • Fear of being harmed during sexual intimacy
  • Fear of sexual performance failure
  • Unwanted sexual fantasies
  • Fear of unwanted attraction (children, animals, family members, inanimate objects)
  • Fear of becoming violent during sex
  • Fear of having a groinal response in response to unwanted stimuli or thoughts
  • Fear of rejection or ridicule
  • Fear of unwanted outcomes, such as accidental impregnation
  • Fear of contracting sexually transmitted illness

Common triggers 

People with a fear of sex in OCD may be triggered by situations involving acts of sex, taboo thoughts, or feelings of sexual attraction in any circumstance. People with unwanted sexual obsessions often feel guilt, shame, embarrassment, and hopelessness when exposed to their triggers, often feeling as if their character is in question. 

Common triggers for people with Sexual OCD include:

  • Having a thought or image during sex (family member, friend, colleague, child, animal)
  • Seeing the object of their intrusive thoughts 
  • Feeling sexual attraction in a way that conflicts with their values or identity
  • Sexual interest reciprocated by someone else
  • Hearing about others’ sexual experiences, negative or otherwise
  • Engaging with sexually explicit media: movies, TV, books, music

How can I tell if it’s Sexual OCD, and not a Specific Phobia like Erotophobia or Genophobia?

When diagnosing OCD, clinicians first consider two main groups of symptoms that characterize the condition: obsessions and compulsions. 

Obsessions are recurring and intrusive thoughts, images, feelings, or urges that bring distress, anxiety, or fear. In a Specific Phobia diagnosis, there may not be intrusive thoughts present, while OCD will always present with intrusive thoughts, urges, or images. 

When people with OCD experience obsessions that cause anxiety, they feel a strong urge to engage in compulsions to feel better. Compulsions are done in an attempt to relieve the anxiety that comes from obsessions, or to prevent a feared outcome related to one’s fears. Compulsions may be mental or physical, often difficult for even those with OCD to notice. The nature of one’s responses to their fears is also important in distinguishing OCD from other conditions like Genophobia or Erotophobia. 

What is a Specific Phobia?

People often mistakenly believe that phobias are a form of OCD, but this is not the case; Specific Phobia is an entirely distinct diagnosis. According to the DSM-5, a Specific Phobia is a “marked fear or anxiety about a specific object or situation.” Erotophobia and Genophobia fall under the Specific Phobia diagnosis and differ slightly, even though the terms will sometimes be used interchangeably. Genophobia is used to describe the fear of sexual intercourse specifically, while Erotophobia refers more generally to a fear of any type of sexual activity, contact, or even sexual content or themes.

In a Specific Phobia, there is often a lack of intrusive thoughts, urges, or images. A person with Erotophobia or Genophobia will fear a specific phobic stimulus, without the underlying obsessions that characterize OCD. 

Symptoms that present when a person is faced with their phobic stimulus may include:

  • Intense fear when faced with sexual intimacy
  • Panic attacks
  • Avoidance
  • Nausea
  • Sweating
  • Tension
  • Headache
  • Dizziness
  • Having a hard time concentrating

Like compulsions in OCD, a person diagnosed with a Specific Phobia will go to great lengths to avoid the act of sex or exposure to their phobic stimulus (sex, nudity, sexual fluids). They may alienate their sexual partners, make excuses to avoid sex, and even sabotage their relationship because of their fear. 

Common compulsions 

When people with a fear of sex experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in compulsive behaviors in an attempt to reduce their distress and anxiety or to avoid an unwanted outcome. 

Compulsions or safety seeking behaviors performed mentally or physically by people with a fear of sex, whether in OCD, Erotophobia, or Genophobia, may include:

  • Avoidance of sex
  • Seeking reassurance about fears from a partner
  • Sabotaging relationships on purpose
  • Making oneself unavailable for sexual relationships
  • Distracting oneself during sexual encounters
  • Thought replacement during sex/trying to push unwanted urges or images away
  • Avoidance of media or other content involving sexual themes 

How to overcome fear of sex 

Sexual themes of OCD, Erotophobia and Genophobia can be debilitating, but all forms of OCD and Specific Phobia are highly treatable with a particular form of therapy called exposure and response prevention (ERP) therapy. This evidence-based treatment has shown to be highly effective in allowing people to manage either condition. 

People who struggle with OCD or a Specific Phobia related to the fear of sex can work with their therapist to build an exposure hierarchy: usually an ERP therapist will start with an exposure that is predicted to bring about a low to moderate level of fear and anxiety and work up to the harder exposures as confidence is built. 

When engaging in exposure exercises, the goal is always response prevention: your therapist will guide you in resisting the urge to respond to fear and anxiety by doing compulsions or avoiding triggers. Over time, this allows you to tolerate anxiety and fear without relying on compulsions or avoidance to feel better.

Examples of possible exposures done to treat a fear of sex include: 

  • Writing down the worst-case scenario of one’s fears being true
  • Reading about the nature of different sexual fluids
  • Watching movies where people are kissing or hugging 
  • Having sex with a partner and, if an intrusive thought occurs, not engaging with it or resisting it

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