Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Is it normal to question my sexuality for years? A therapist weighs in

By Elle Warren

Nov 27, 20239 minute read

Reviewed byApril Kilduff, MA, LCPC

Identities can be complicated. In many ways, they continue to evolve as we get older, learn more about ourselves, and learn more about how we want to engage with the world around us. 

Sexuality can be complicated for its own specific set of reasons. While we have made significant strides in rights for and acceptance of queer people, we still have a ways to go. Plus, much of that significant progress has been recent, and many of us grew up internalizing harmful messaging about queer people and what it means to be anything but straight.

I know how frustrating and uncomfortable it can be to have persistent uncertainty, doubt, and confusion about your sexuality. I experienced intense, distressing questioning around my sexuality for the better part of a decade. I treated it as an equation to be solved, and I couldn’t stop plugging in different figures. I also happened to have some long-ingrained beliefs that led me to think that being anything other than straight would condemn me to a small, sad, horrible life. Thus, the stakes felt incredibly high.

Ultimately, with the right kind of help and work, I gained an understanding and even appreciation for the uncertainty and fluidity that surrounds individual identities. All this is to say that while questioning your sexuality can feel like an isolating experience, you’re far from alone. Continue reading for more information on why you might be questioning your sexuality, when doing so can move from normal to unhealthy, and how you can get help if it’s bringing high levels of distress to your life.

Why are you questioning your sexuality?

First of all, know that questioning your sexuality is not a bad thing. In fact, it can be very healthy and necessary to question and examine our identities, including but not limited to sexuality, throughout our entire lives.

Moreover, there are many people who are completely comfortable questioning their sexuality. They may find it enriching to contemplate this part of themselves. For some, having a fluid or “uncertain” sexuality may actually be a core part of their identity that they embrace and love.

For others, it may feel painful and difficult. It can be uncomfortable to feel like you don’t know who you are. In some cases, it’s possible the questioning of your sexuality has more to do with the question of whether or not you want to come out to others—or even to yourself. April Kilduff, MA, LCPC, LMHC, a specialist in obsessive-compulsive and anxiety disorders, says that “this is often the part that takes a long time.” You may know your sexuality but not know how to actually live it.

There’s also a common mental health condition called sexual orientation OCD, shortened to SO-OCD. This is a theme of obsessive-compulsive disorder (OCD) that focuses on knowing your “one true” sexual orientation. This is when questioning your sexuality becomes unhealthy, as OCD takes up a significant amount of time, spurs intense feelings of distress/anxiety, and causes you to engage in compulsive behaviors in an attempt to gain 100% certainty and reassurance about your sexuality. 

If those feelings resonate with you, you could be experiencing SO-OCD.

What is sexual orientation OCD?

SO-OCD can occur in people of any sexuality, not just straight people. Like all themes of OCD, the disorder consists of persistent, unwanted intrusive thoughts, images, urges, feelings and/or sensations (obsessions), extreme distress or anxiety that comes as a result, and physical or mental behavior (compulsions) done in attempt to relieve that distress.

Intrusive thoughts can sound like:

It’s important to note that everyone has intrusive thoughts—they’re a universal experience. What differentiates people with OCD is the way they interpret those intrusive thoughts, and what they do as a result. Someone without OCD may have one of the above thoughts, recognize it as inconsistent with who they are, and move on with their day. Or, if a thought about their sexuality piques their interest, they can take it seriously as something to think about, without feeling particularly distressed or anxious about it.

Someone with OCD, on the other hand, will become highly anxious and feel a desperate, urgent need to find “the right answer” to their intrusive thoughts immediately. As a result, they turn to compulsions for a sense of certainty or relief. Here are a few examples:

  • Rumination. You might spend hours turning the same thoughts over and over in your head: What does this mean? What am I missing?
  • Mental review. For example, you may look back on all the times you’ve hung out with your best friend, asking yourself, Was I flirting there? Was that a sign that I’m secretly in love with her?
  • Seeking reassurance from yourself or others. You might ask a friend, “Was that dude at the bar hitting on me?” or as your partner “Don’t we just have the best relationship?” 
  • Avoidance. You may avoid eye contact with people of certain genders, avoid going out altogether, avoid dating, or even avoid your partner.
  • Checking physical sensations. People with SO-OCD tend to be highly aware of their physical sensations, particularly groinal responses. As such, they may even watch porn in order to “check” their arousal.
  • Praying. You may pray, even dozens or hundreds of times per day, for clarity on your sexuality, to “not be gay,” or to be forgiven for your “sins.”
  • Conducting excessive online research. Kilduff notes that many people will spend hours taking online sexuality quizzes or watching TikTok videos about people who realized their sexuality later in life, comparing the details of their own life to those of the people in the videos.

Of those suffering from this theme, Kilduff says, “There’s a need for certainty because of the fear that they’re not being their true selves, and that they might hurt people in the process if they’ve been claiming the wrong sexual orientation. It’s often about ‘what is the impact this is going to have on other people?’” 

How do I know if it’s OCD or just typical questioning? 

If you are genuinely questioning your sexuality, without the presence of OCD, you may still feel some level of anxiety and fear due to the overall discomfort of an uncertain identity and, potentially, internalized beliefs about certain sexualities. However, you may also feel excitement, hope, and joy. Moreover, it is probably not taking up huge portions of your day, it probably feels less urgent, and you’re probably less concerned with never knowing your “one true” sexuality. 

In other words, you’re not having repetitive, unwanted intrusive thoughts, high levels of anxiety over them, and engaging in mental or physical compulsions as a direct response.

In my personal experience, I can now a clear difference between the questioning I experienced in the throes of SO-OCD and the questioning I engaged in after. When I was no longer afraid to be any one sexuality, and when I let go of a need to know for sure, questioning my sexuality felt joyous and freeing. It was fun to realize I could be who I wanted—and that I might not feel the same forever. 

The questions I was asking myself were no longer urgent and demanding, but rather non-judgemental and non-expectant. They sounded more like:

In short, I stopped treating sexuality like a math equation. I lowered the stakes and gained a sense of acceptance—a sense of comfort without certainty. 

It’s also possible that you’re experiencing SO-OCD and genuinely questioning your sexuality at the same time. If you think you could be experiencing OCD, the best way to find out is to consult with a therapist who specializes in OCD treatment and practices exposure and response prevention therapy (ERP). Many professionals who have experience and training in ERP also have particular experience and skills in providing affirming and empathetic care for experiences related to sexuality and identity.

How can I get help and guidance?

All themes of OCD are treated with ERP. This modality of therapy works by guiding you in facing your fears and not reacting to them with compulsions, learning to accept uncertainty and anxiety along the way. 

You and your therapist will first identify what your intrusive thoughts, doubts, and questions sound like, and the circumstances when they occur. Once you better understand the nature of your obsessions and doubts, you’ll start engaging with them directly, through careful and intentional therapy exercises.

Kilduff offers a few examples of specific exercises she might guide clients with SO-OCD through:

  • Hanging up a rainbow Pride flag
  • Thinking of the most attractive celebrities of the gender you’re worried you’re attracted to and looking at pictures of them
  • Writing down “worst case scenarios,” such as, “If I’m actually straight, then…” and reading it back to yourself
  • Watching videos of people who realized their sexuality was different than they thought without comparing yourself to them

By not engaging in compulsions for a false sense of relief or “certainty,” your brain learns that intrusive thoughts are not a threat. And while you’ll still have intrusive thoughts or doubts from time to time, because we all do, your anxiety over them will significantly decrease. You will learn that you can tolerate uncertainty about your sexuality—just as you do in other parts of your life.

Note that the goal of treatment in SO-OCD is not to discourage you from questioning or exploring your sexuality. Rather, the goal is for you to let go of the need to be 100% certain of your sexuality. It aims to help you be okay with ambiguity and stop engaging in the obsessive-compulsive cycle. In fact, ERP tends to help people gain a greater ability and motivation to explore their sexuality further, without the pressure of needing to feel certain.

If you think you may be struggling with SO-OCD and would like to gain greater freedom and confidence in your identity, I strongly encourage you to learn more about NOCD’s evidence-based, accessible approach to treatment for OCD and related conditions like anxiety. NOCD Therapists have received intensive, specialized training in ERP therapy, and you can work with someone who is empathetic, affirming, and informed about treating people of all identities.

If you don’t resonate with the information on OCD, but would still like help in navigating the process of questioning your sexuality and/or coming out, look for a cognitive behavioral therapist that specializes in working with LGBTQIA+ populations. You can request a brief consultation with them before scheduling to ensure that they are affirming of all identities. 

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