Obsessive-compulsive disorder (OCD) is a chronic mental health condition in which a person experiences upsetting repetitive thoughts (obsessions) as well as ritualistic behaviors that are repeated over and over (compulsions). There are different subtypes of OCD, and it can present in a variety of ways.
Questioning your sexual orientation and exploring your sexuality are both normal and healthy things, but if the questioning becomes intrusive and distressing and is accompanied by repetitive behaviors, it might be sexual orientation OCD (SO-OCD).
Read on to find out more about SO-OCD and how it’s treated.
What Is Sexual Orientation OCD?
SO-OCD used to be referred to by the now-outdated term homosexual OCD (HOCD). It is marked by intrusive thoughts and compulsions around sexual orientation.
A person with SO-OCD constantly agonizes over their sexuality and may also worry that others perceive them as having a different sexual orientation than the one they identify with. These obsessive thoughts are unwanted and are different from sexual thoughts that the person finds pleasurable.
In response to their obsessive thoughts, the person may engage in compulsive behaviors like looking at pictures to “test” whether or not they become aroused, excessively seeking reassurance from others, or avoiding standing too close to or touching others.
SO-OCD vs. Questioning Your Sexuality
Many people explore their sexuality and question their sexual orientation, but SO-OCD is different. The thoughts and behaviors that accompany SO-OCD are intrusive, disruptive, and take up more than an hour a day. They often trigger feelings of guilt and shame, too.
Signs and Symptoms of SO-OCD
Common intrusive thoughts and compulsive behaviors in SO-OCD can include:
- Doubting your sexual orientation even though you have no rational reason to do so
- Ruminating about past sexual experiences and social interactions
- Compulsive fantasizing about different sexual behaviors to see if you become aroused
- Persistent worry you are sending out “signals” that make others think you are of a different sexual orientation than you are
- Excessively seeking reassurance from others
- Avoiding social situations where you may need to stand near and could potentially touch other people
Treatment for SO-OCD
The treatment for SO-OCD is similar to what’s used for other types of OCD. But each person is different, and treatment plans can vary.
Exposure and Response Prevention
Exposure and response prevention (ERP), a type of cognitive behavioral therapy (CBT), is typically the first-line therapy for OCD. This type of therapy exposes the individual to their anxiety triggers while also preventing them from performing compulsive behaviors.
This helps teach them how to tolerate distress; they also learn healthier ways to manage their anxiety when obsessive thoughts crop up. The goal is to break the obsession-compulsion cycle.
OCD Support Groups
An OCD support group could help you feel better understood and less lonely. It isn’t a substitute for individual therapy, but it can be a helpful component of your treatment plan. People who understand what it’s like to live with SO-OCD and the accompanying obsessions and compulsions can validate your experiences while sharing advice on how to manage the condition.
Diet and Lifestyle Changes
Research has shown that lifestyle factors such as diet and exercise can influence how successful the treatment of an anxiety disorder is.
Regular exercise can help with stress relief, and a healthy diet can have a positive effect on mental health. Talk with your healthcare provider about lifestyle changes you can make that could benefit both your body and mind.
Mindfulness is sometimes part of the therapy for OCD. It focuses on paying attention to the thoughts and feelings of the present moment, without assigning judgment or analysis. By calmly accepting them and letting them pass, you may eventually become less dependent on compulsions to relieve anxiety.
Stress can often make symptoms of OCD worse, and many people report that a stressful or traumatic incident was a trigger for their OCD.
In addition to the lifestyle changes and mindfulness exercises mentioned above, ways to manage stress include:
- Get enough sleep.
- Avoid excessive use of alcohol or recreational drugs.
- Maintain connections with others.
SO-OCD is marked by intrusive thoughts and compulsive behaviors around questioning one’s sexual orientation. This isn’t healthy, normal questioning of sexual orientation: The obsessions and compulsions are unwanted and distressing, and they take up more than an hour a day. The gold standard treatment for SO-OCD, like all types of OCD, is ERP, but support groups, mindfulness exercises, diet and lifestyle changes, and stress management may also be helpful.
A Word From Verywell
It’s normal for people to question their sexual orientation, and doing so can bring up uncomfortable feelings from time to time. The difference with SO-OCD is that it’s marked by upsetting obsessions and compulsions that can interfere with daily life. A good therapist and treatment team will be able to tell the difference between normal questioning of sexuality and SO-OCD.
Frequently Asked Questions
There is no single, definitive cause of OCD. Genetics, brain chemistry, and environmental factors are all thought to play a role. SO-OCD has long been understudied, and more research is needed.
SO-OCD involves obsessive and intrusive thoughts and accompanying compulsive behaviors to relieve the anxiety. These thoughts and behaviors are time-consuming, taking up at least an hour a day, and they can disrupt your daily life. This makes it different from the typical questioning of or denying your sexual orientation.
It’s not known for certain how common SO-OCD is, but initial studies have found that about 25%–30% of those with OCD report having sexual obsessions. SO-OCD is not always well-understood by mental health professionals, so it’s possible these numbers are underreported.