What is HOCD?

It goes by many names.  HOCD, Gay OCD, Sexual Orientation OCD, or, if you suffer from it, your own personal nightmare.  You know yourself to be of one orientation, but your mind starts telling you that you secretly belong to another.  It’s not homophobia, it’s not denial, it’s a form of obsessive compulsive disorder, an obsession with sexual orientation.

It follows the same rules as other forms of OCD of course.  It has the obsession, an unwanted intrusive thought:

  • the fear of becoming gay (or some orientation not your own)
  • the fear of being seen as gay
  • fear of relationship issues being signs of sexual orientation issues
  • the fear of being in denial (or so secretly gay even you don’t know about it)
  • the fear that intrusive thoughts will ruin your sexual performance and/or that difficulty performing sexually is a sign of your orientation changing
  • the fear of losing your sexual identity

It’s not just “what if I’m gay?”  If it were that easy, you could put it to rest with, “Well, I’ll be gay then and my gay self will be cool with it.”  It’s a fear of being trapped, of losing your sense of self.  It’s a fear of the “straight” you somehow getting lost in a metamorphosing gay body, never being able to return to that connection you once had with your sexuality and the people you were attracted to, and being held responsible for failing to realize it in time.

It has compulsions, many of them covert, easy to rationalize as just “figuring things out” but no less ritualistic than counting to your favorite number while washing your hands in scalding water to ensure you are clean.

Physical compulsions common in HOCD:

  • Avoiding all things you may associate with homosexuality – types of music or movies, gay neighborhoods, the gym, types of fashion, colors, cadences of speech, styles of singing or dancing…
  • Physically checking of your groin to see if there is any sensation going on down there that you’ve deemed a gay response, hoping to find nothing.  But because over-attending to any body part causes sensations, you inevitable find something and analyze why.
  • Physical forms of reassurance seeking, such as compulsive masturbating to straight pornography while checking to be sure you like it, compulsively looking at gay pornography while checking to be sure you don’t like it
  • Staring at people you think you’re supposed to be attracted to and looking away from people you think you’re not supposed to be attracted to.  Or staring at people you think you’re not supposed to be attracted to as a form of checking.
  • Asking for reassurance to see if others think you’re gay or manipulating people into commenting on your “straightness”

Mental compulsions common in HOCD:

  • Neutralizing thoughts with self-reassurance (i.e. repeatedly saying “I’m not gay” or “gross, that’s not me”)
  • Scenario bending – playing imaginary scenarios in your head to determine if you would or would not enjoy engaging in a gay behavior
  • Mentally reviewing your past sexual experiences to see if there were any signs or evidence of gayness.  This may include over-analyzing any same-sex experiences you may have had to determine if they define your sexual orientation.
  • Mentally reviewing recent interactions to see if you felt gay or if others saw you as gay
  • Praying or doing other mental activities in response to the presence of gay thoughts in an attempt to make them go away
  • Compulsive fantasizing about “straight behaviors”
  • Compulsive fantasizing about gay behaviors for the purpose of checking if you like them (sometimes called compulsive flooding)
  • Ritualistically lamenting the presence of gay thoughts, devoting time to wishing they weren’t there, that you’d never thought them in the first place

Though I have treated this many times, enough that I felt compelled to write blogs about it before, people tend to underestimate how common a form of OCD this is.  You may be afraid to call it OCD because in the throes of the obsession, it feels like that could just be an act of denial.  If I call it OCD, how will I know for sure that I’m not also gay?  You may be afraid to share your fears with friends, who may mock you or secretly pretend to “get it” when they really just think you’re gay and won’t admit it.

You may be afraid that your therapist will join you in the analytical pursuit of meaning, rather than help you, and then try to get you to accept a homosexuality in you that doesn’t really exist.  It’s true that therapists who are not OCD specialists may be more psychodynamically trained and feel pressure to view HOCD as an identity issue when it is not.  It’s not even a sex issue.  It’s an issue of obsessing over uncertainty and engaging in compulsions in the futile pursuit of that certainty.  It’s about washing the sexual mind of perceived contaminants as someone else might wash their hands.

“I know I’m not gay, but this thing has made me lose confidence in knowing what I am, which means I could be gay, which means I can’t stop thinking about it until I prove I’m straight.”

Common things I hear from straight people with HOCD:

  • Why do I keep getting thoughts of kissing my friend?
  • My straight relationships have always been full of conflict and it would be easier if I were gay.
  • Why do I notice members of the same sex at all?
  • Isn’t calling this OCD just a way of avoiding calling it denial?
  • I’m not as attracted to members of the opposite sex as I used to be.
  • I’m not homophobic at all.  In fact, I a big supporter of gay rights.  Does this mean something?
  • If I were totally straight, this obsession wouldn’t keep coming back.
  • There’s something happening in my groin and it means I’m reacting to members of the same sex and straight people don’t do that.
  • If I don’t read about HOCD, I won’t be able to handle the anxiety of thinking I could be gay.
  • My therapist is just waiting for the right time to refer me to an LGBT specialist.
  • It’s something.  It’s not sexual arousal, but it’s not nothing.  What is it????
  • Exposure therapy is going to make me feel ok with gay thoughts, which is going to make me gay.
  • If I live in denial and wake up to being gay one day, everyone will think I’m so stupid for not having known and everyone will hate that I wasted their time knowing me.

Along with HOCD often comes brutal self-esteem hits, depression, and social anxiety.  If you suffer from sexual orientation obsessions, it can feel like you don’t know who you are anymore, like your true self is locked away and this “other” is taking over your life.  It can keep you from fully experiencing your romantic relationships, your friendships, and everything up to and including dreams.  It may not seem like it, but all OCD is this way.

Jon Hershfield, MFT is a psychotherapist in private practice licensed in Maryland and California, specializing in the treatment of OCD.  Follow him on Twitter and Facebook

Click here for HOCD: Part 4

Click here for HOCD: Part 3

Click here for HOCD: Part 2