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What is OCDRelated Symptoms & ConditionsWhat you need to know about Compulsory Heterosexuality (Comphet) and Sexual Orientation OCD 

What you need to know about Compulsory Heterosexuality (Comphet) and Sexual Orientation OCD 

10 min read
Grant Stoddard

By Grant Stoddard

Reviewed by Patrick McGrath, PhD

May 11, 2023

You’ve always known yourself to be of one sexual orientation, but suddenly your mind starts telling you that you secretly belong to another. Or you’re having intrusive thoughts about being attracted to someone you didn’t think you even could have feelings for, given your orientation. When these types of confusing experiences arise, you may wonder: “Have I been in denial? Is something wrong with me? Am I living a lie? How can I get rid of these thoughts?” 

The good news, despite how distressing this can all be, is that you’re not alone. In fact, there are names for the things that might contribute to what you’re feeling. The first is comphet, or “compulsory heterosexuality.” This is the idea that society pressures people to be heterosexual, conform to heterosexual behavior, and hide or suppress their true identity. Comphet can lead people to feel shame, doubt, and distress about their sexuality, and even about their identity in general. The other is a mental health condition called sexual orientation OCD (SO-OCD)

SO-OCD can lead people on a road of doubt and uncertainty about who they are, what they believe, and why. SO-OCD could begin simply by smiling at someone and then wondering why you did. “Did I smile to be nice? Maybe I smiled because, without knowing it, I am attracted to them and I actually want to be with them instead of my (insert gender here) partner.”

Doubts and worries about your sexuality might come from comphet, SO-OCD, or both at the same time. Since comphet and SO-OCD need to be dealt with differently, it’s important to understand the differences.

Understanding Compulsory Heterosexuality (Comphet)

What is comphet? 

The term comphet describes the societal pressure to conform to heterosexual norms and behaviors, even if they don’t align with a person’s true sexual orientation. This pressure can be highly subtle or completely apparent, and can come from various places, including family, media, education, religion, and broad social norms.

Comphet can impact anyone regardless of their gender, sexual orientation, or age. However, it is most commonly associated with people who identify as LGBTQ+ and have experienced pressure to conform to heterosexual norms and behaviors.

Comphet can affect people who are aware of their true sexual orientation but cannot express it due to external pressures, and those who are unaware of their sexual orientation due to internalized societal norms and expectations. It can also impact people who are still exploring their sexual identity, as well as others who may not have the language or resources to express their true identity.

How might people experience comphet? 

Comphet can impact people differently and cause a wide range of individual experiences. However, some everyday struggles that people with comphet may encounter include:

  1. Having a hard time envisioning oneself in a same-gender relationship due to internalized heteronormative beliefs and societal expectations.
  2. Feeling pressure to date or have sex with people of the opposite gender to fit in or prove one’s heterosexuality.
  3. Denying or hiding one’s actual sexual orientation due to fear of rejection, discrimination, or violence.
  4. Avoiding experiences, friends, social groups, and personal interests for fear of negative consequences.
  5. Struggling to find community and support within one’s family, social circle, or workplace due to homophobia, transphobia, and lack of representation.

Because many people with comphet internalize the idea that they have to be attracted to the opposite sex, they may miss out on valuable relationships and experiences, and can experience intense distress and shame. It’s important to recognize and address the impact of comphet to create a more inclusive and accepting society for everyone. 

So how does comphet differ from OCD? Let’s explore how the two differ from one another, and how they can be related.

Sexual orientation OCD (SO-OCD)

SO-OCD is a subtype of obsessive-compulsive disorder (OCD). Before going into detail about this particular subtype, let’s learn a bit about OCD, a highly misunderstood and potentially debilitating condition. 

OCD is a mental health disorder characterized by recurring, intrusive, and unwanted thoughts, images, and urges (obsessions) and repetitive mental or physical behaviors (compulsions) that a person feels compelled to perform in response to them. 

Everyone has odd, unwanted, intrusive thoughts from time to time. People without OCD are generally able to dismiss these thoughts, images, or urges as unimportant and move on with ease. People with OCD, on the other hand, worry that their intrusive thoughts are meaningful and urgent, making them feel extremely anxious or distressed. A person with an OCD subtype known as Harm OCD, for instance, might have an intrusive thought like this:

What if I pushed that guy off the subway platform and onto the tracks?

Most people might notice the thought, find it a bit unpleasant, and shrug it off. A person with Harm OCD, however, will fixate on the potential meaning of the thought, unable to let it go:

Does that mean I’m capable of doing that? Am I a monster? I can’t be trusted in public.

The same intrusive thought is now an obsession, resulting in fear, uncertainty, and doubt, and the person’s mind is racing to find ways they can feel better by doing compulsions. For example, a person obsessed with the thought of pushing someone onto the tracks might make a point of standing well away from other passengers, repeatedly tell themselves that they could never do such a thing, or avoid taking the subway altogether. 

Any relief these compulsions bring will be short-lived, as OCD demands perfect certainty that the person in its grip won’t act upon their obsessive thought, image, or urge. Unfortunately, perfect certainty is impossible to attain, and these compulsions ultimately reinforce what’s called the OCD cycle.

Break the OCD cycle

SO-OCD is characterized by intrusive thoughts and compulsive behaviors related to one’s sexual orientation. People with SO-OCD experience intrusive thoughts and urges related to denial or confusion about their sexual orientation, often worried that they are living a lie or are unable to know themselves. 

People with Sexual Orientation OCD (SO-OCD) may excessively scrutinize their thoughts and behaviors, and have persistent concerns about whether their desires align with a particular sexual orientation. 

For instance, they may question why they looked at a person of the same gender and wonder about the meaning of their attraction to certain people, or they may have intrusive thoughts during sexual intimacy that feel impossible to dismiss. The fear of being uncertain about one’s sexual orientation can take over their thoughts and leave them searching frantically for evidence about their true identity. These thoughts and behaviors can be highly distressing and interfere with a person’s social life and relationships.

Therapists who treat SO-OCD often report that patients are not necessarily worried about their sexuality itself, but that the uncertainty and doubt they feel about their identity is highly distressing and overwhelming. They might say, “I don’t care if I’m gay or straight; I just want to know for sure.” Consequently, people of any sexual orientation may develop SO-OCD, since the condition is not about their actual sexual identity, but rather about doubts that can affect anyone.

Do these symptoms sound familiar? Learn how you can overcome them.

Here at NOCD, we know how overwhelming OCD symptoms can be. You’re not on your own, and you can talk to a specialist who has experience treating OCD.

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The relationship between comphet and SO-OCD

While comphet and sexual orientation OCD are related in that they both involve anxiety and distress related to one’s sexuality, they are distinct. Comphet is a social and cultural phenomenon, while sexual orientation OCD is a mental health disorder. People can experience comphet and sexual orientation OCD simultaneously, but one does not necessarily cause the other.

It is important to note that experiencing distress about one’s sexual orientation is not a disorder in and of itself. However, if these thoughts and feelings become highly distressing or interfere with your daily life, it may be a sign of a mental health condition like OCD.

Now that we’ve got a better understanding of what comphet and SO-OCD are, let’s look at ways you can overcome the impact they can have on your life.

Exposure and Response Prevention (ERP) therapy for SO-OCD

Exposure and Response Prevention (ERP) therapy is the primary treatment option for people with any OCD subtype, including SO-OCD. 

ERP works by exposing people to their feared thoughts or situations while guiding them to resist engaging in compulsive behaviors. ERP aims to help people develop a new way of responding to their obsessive thoughts without perpetuating the OCD cycle and making their fears worse over time.

During ERP therapy, you’ll work with a therapist to develop a hierarchy of feared situations or thoughts. Starting with the least distressing situation or thought, you’ll be exposed to it while refraining from engaging in compulsive behaviors. The exposure may involve imagining a feared situation or actually confronting it in real life. Exposures done in treatment for SO-OCD may include exercises like these:

  • Writing about ending a long-term relationship due to doubts about your sexuality, and reading it aloud.
  • Looking at pictures of people of a gender you’re not typically attracted to and saying, “I may or may not be attracted to them—I can handle that.”
  • Reading stories about others who have experienced long-term doubts about their sexuality or who have fluid sexual identities.

Your therapist will guide you through the exposure and help you resist the urge to engage in compulsive behaviors. Once you’ve successfully completed the exposure, they will move on to the next item on the hierarchy and repeat the process. Over time, you become better able to sit with the distress brought about by your obsessions and triggers, allowing it to decrease over time without relying on compulsions for short-lived relief.

Unlike traditional talk therapy, which may unknowingly accommodate safety-seeking compulsions like reassurance-seeking, ERP takes a targeted approach to address specific obsessions and compulsions and stop the vicious cycle of OCD. 

Getting help for SO-OCD

If you’re interested in learning about SO-OCD and how it’s treated with ERP, you can schedule a free call with the NOCD Care team to find out how this treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD and understand ERP therapy’s importance. 

NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during your treatment. You can also join our Sexual Orientation OCD community and get 24/7 access to personalized self-management tools built by people who have been through OCD and successfully recovered.

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Overcoming the impact of comphet

The effects of comphet can be challenging to surmount. There’s no one way to deal with its numerous and far-reaching impacts, but with the proper support and resources, it is possible to find lasting confidence, comfort, and affirmation in your identity. 

If you feel as though you are having doubts about your sexuality due to comphet, here are just some of the steps you can take: 

Self-exploration: Engage in self-reflection and explore your thoughts and feelings about your sexual orientation. This can involve talking to trusted friends or family members, keeping a journal, or seeking the help of a therapist.

Educating yourself about comphet: Educate yourself about comphet and its effects on people. It can help to read books, articles, and other resources that provide information and insights about comphet, sexual orientation, and LGBTQ+ issues.

Joining a support group: A support group or community can provide an opportunity to connect with others who have experienced similar struggles. This can help to reduce feelings of isolation and provide a supportive environment for exploring one’s sexuality.

Seeking Professional Help: Consider seeing a therapist or counselor who is experienced in working with individuals who have experienced the effects of comphet. They can help identify and address underlying emotional or psychological issues that may contribute to your doubt and distress.

Learn more about ERP