OCD Identity Issues: Thoughts, Fears, and Causes

OCD can’t cause gender dysphoria. But transgender OCD is an OCD theme that can cause you to question your sexual orientation.

Transgender OCD, questioning your gender, and gender dysphoria are not all the same thing.

If you aren’t sure which you’re experiencing, then it’s important you see a mental health professional who specializes in OCD.

Transgender OCD was first referenced in 2015, and there’s little information and research about it. So, not much about this OCD theme is understood, even within the mental health community.

Transgender OCD

People with transgender OCD often have intrusive obsessions about their gender identity. You may have the thought, “What if I’m in denial about my true sexual orientation.”

So, people who are cisgender might worry about being transgender, and people who are transgender might have thoughts that they’re actually cisgender.

Transgender OCD vs. gender dysphoria

The existence of transgender OCD has led to discussions about how to differentiate this condition from gender dysphoria, the diagnosis used for people who feel uncomfortable that their physical sex characteristics don’t match their experienced gender.

Both these conditions can cause distress but for very different reasons.

Characteristics of gender dysphoria

People with gender dysphoria often have feelings of distress because there’s a difference between their experienced gender and their sex characteristics.

Other features of gender dysphoria can include:

  • a strong desire to get rid of your sex characteristics
  • a strong desire to be perceived and treated as of another gender
  • a conviction that you have the psychological characteristics of another gender

Transgender OCD symptoms

In contrast, people with transgender OCD don’t typically have a desire to get rid of their sex characteristics or to be another gender.

People with transgender OCD usually have obsessions about the possibility that they could be another gender, often experiencing these obsessions as fearful or repulsive.

Questioning your gender with transgender OCD doesn’t usually feel like who you really are is another gender. For people who may question their gender, being of another gender usually feels more natural than the one assigned at birth. Additionally, there’s often a desire to transition.

In other words, these thoughts are ego-dystonic — as OCD thoughts generally are.