What is Homosexual OCD?
Homosexual OCD (HOCD) is a type of Pure Obsessional OCD that involves an individual’s repeated and unwanted obsessions with their sexual orientation. This is such that an individual who is heterosexual may experience obsessive fears about being homosexual while a homosexual individual may experience obsessive fears about being heterosexual.
HOCD occurs in both males and females and is characterized by discomfort surrounding uncertainty about one’s sexual orientation and compulsive behaviours to diminish discomfort such as avoidance, reassurance-seeking and mental compulsions. It is notable that the obsessions experienced within HOCD are not related to confusion about sexuality but rather HOCD is characterized by distressing thoughts about sexuality that directly contradict an individual’s sexuality.
There are a number of different types of HOCD, which are as follows:
Individuals may find they identify with a number of different categories.
This type of HOCD is experienced by individuals who have always been one sexual orientation and have never experimented with or questioned their sexuality and find they have a singular thought that contradicts their sexuality leading them to question their orientation and experience distress. The distorted pattern of thinking underlying this is the belief that individuals of one orientation never experience thoughts pertaining to another orientation when, in fact, this is a common occurrence that is not typically inferred as an indicator of sexuality.
Relationship HOCD pertains to individuals who attribute their past failings in relationships to their sexuality, citing that the relationships must not have succeeded as they were not attracted to their partner as a result of their conflicting sexuality. Typically individuals experiencing Relationship HOCD find they do not relate well to the opposite sex and relate better and spend more time with those of the same sex resulting in the individual’s fearful questioning of their sexuality.
This type of HOCD typically results from a history of mistreatment, abuse or bullying that more so causes depression than confusion regarding sexuality. In this form of HOCD an individual sees the negative beliefs instilled in them through abuse to be analogous with being gay and thus feels a deep sense of depression regarding their status as ‘unlovable’ or unattractive.
‘Real Man/Real Woman’ HOCD
This type of HOCD concerns an individual’s beliefs regarding stereotypical male and female gender roles such that the individuals believes that their inability to fulfill their expected gender role has implications for their sexual orientation that are unwanted.
Groinal Response HOCD
Groinal Response HOCD is characterized by the distress that an individual experiences as a result of sexual arousal or groinal responses that they have experienced in response to a situation or stimulus that they believe does not conform with their sexual preferences. Such that the individual believes that any groinal response to such a stimulus or situation is evidence that they are sexually oriented towards that gender despite no desire or attraction towards that gender.
What are the symptoms?
The common symptoms associated with Homosexual OCD are as follows:
- Obsessive worry resulting in distress or disgust regarding the possibility that one’s sexuality may be contrary to what they believe it to be.
- Rumination on feelings of doubt regarding sexuality.
- Believing that normal thoughts and feelings about members of the sex you are not attracted to are indicative of your attraction towards them.
- Imagining scenarios that are inconsistent with your believed sexual orientation to ascertain whether you are sexually aroused.
- Looking for outward signs that you are walking, talking, dressing, gesturing or interacting with others like someone who is heterosexual or homosexual.
- Questioning others about your sexuality or turning to the Internet to read coming out stories or information about sexuality to ascertain whether you identify with the stories and information.
- Avoidance of people or situations in which one believes they will become aroused by stimuli contrary to their believed sexual orientation.
Why does it occur?
Much like other forms of OCD, it is difficult to identify one singular factor that causes HOCD, however, there are a number of factors that may contribute to the development and maintenance of the disorder. This is such that it may be seen that those with HOCD typically have low self-esteem, have experienced difficulty maintaining past relationship or experienced an abusive relationship or traumatic break up, have experienced unsatisfying sex or attribute their virginity to a sexual orientation.
What treatments are available?
A form of Cognitive Behavioural Therapy (CBT) known as Exposure Response Prevention (ERP) had been found to be highly effective in the treatment of Obsessive Compulsive Disorders including HOCD. For those with HOCD this would involve exposure to feared thoughts and situations that trigger the obsession about sexuality without engaging in compulsive behaviours that are used to reduce anxiety. Over time an individual will approach increasingly feared situations and thoughts and continue to engage in a process of acceptance of the thoughts without performing a compulsive behaviour in response to the thought or situation.
Dr Emily O’Leary
- Clinical Director of Anxiety House and OCD Clinicsince 2010
- Ten years’ experience with clients with OCD and anxiety
- Clinical supervisor and STAP trained
- Worked in public and private sectors for many years
- Worked in acute inpatient and outpatients units
- Regular speaker on radio and social media
- Researcher and presenter at international conferences