Gay ocd

Is it the same as SO-OCD?

Yes, HOCD (homosexual OCD) is an older term that refers to the same subtype of OCD, but it’s considered outdated and potentially misleading.

“The term ‘HOCD’ can be misleading because it implies that the fear is about being gay when, in reality, the core struggle in SO-OCD is an intolerance of uncertainty,” explains Nicholas Farrell, PhD, LP, Director of Clinical Development & Programming at NOCD.

They are often a result of hyperfocus and anxiety—not desire.

But ERP is most effective when it’s delivered through an LGBTQIA+-affirming lens, especially when addressing sexual orientation and gender-related fears.

Therapy should be your first port-of-call if you have or suspect you have OCD.

There are, however, some things you can do at home to help with your OCD symptoms. You don’t want these thoughts—you want them to stop.

The key difference lies between distress and desire. Never assume a client questioning their gender or sexuality is “confused” or “exploring,” as it might be OCD, or might not be. In a study of 409 people with OCD, 8% reported having sexual orientation obsessions.

As distressing as they might be, understand that these obsessions are not a reflection of your true self—they’re symptoms of OCD.

Keep reading to learn more about sexual orientation OCD, including symptoms, how it’s different from genuine exploration, and how you can seek help.

What about HOCD?

“Treatments” that try to change your orientation are called conversion therapy. Identity may be part of someone’s OCD, but it isn’t the whole picture.

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The Importance of Affirming Mental Healthcare

Queer and trans people experiencing SO-OCD, GOCD, or any subtype for that matter, can benefit from ERP therapy—an evidence-based treatment helps people confront their fears without relying on compulsions.

These feelings are not just passing curiosities—they are intense and repetitive, driven by OCD’s need for certainty.

Here are a few examples of SO-OCD obsessions:

What if I’m actually gay and I’ve been lying to myself?
What if I lose attraction to my partner?
What if I’m secretly attracted to everyone?
What if I never know my true identity for sure?

These thoughts feel intrusive, unwanted, and persistent—often accompanied by a deep urge to “figure it out.”

Are SO-OCD thoughts different from questioning your sexuality?

Yes.

“When someone has multiple stigmatized identities, such as being a gender or sexually minoritized person and having a mental illness, the issue of safety and support matters that much more,” Dr. Forcier explains. These behaviors are not driven by curiosity—they’re driven by fear and a desire for certainty.

While not a complete list, here are a few examples of SO-OCD compulsions:

Mentally reviewing past relationships
Looking at photos or videos to “test” reactions
Asking others for reassurance (“Do you think I’m really straight?”)
Avoiding people or situations that trigger doubt
Checking for groinal responses or other bodily sensations

Compulsions may bring short-term relief, but they reinforce and intensify the OCD cycle and make symptoms worse over time.

Is SO-OCD the same as being closeted?

No.

Obsessive-compulsive disorder (OCD), a condition characterized by a cycle of intrusive thoughts and compulsions, often targets what matters most—including your sexual and gender identity. “Affirming and inclusive mental healthcare provides that safe space and comprehensive perspective that can help foster healing and growth.”

Part of delivering affirming care means clinicians must screen for OCD without pathologizing LGBTQIA+ identities.

shows there are many effective therapies for treating OCD.

The most common treatment for OCD is a kind of cognitive behavioral therapy (CBT) called exposure response prevention (ERP) therapy. This involves focusing on the form of the distress, rather than just its content. A core fear often emerges: "What if I'm not who I think I am?" For people with HOCD, this uncertainty can spiral into incessant worry and rumination, making it difficult to find relief.

Because OCD follows a cyclical pattern, breaking free from its grip can be challenging.

In this case, you’ll need a prescription from a medical professional, such as a psychiatrist. This approach considers not just the techniques used in exposure, but the ethics—ensuring that treatment doesn’t reinforce stigma or treat marginalized identities as props. Queer and trans people may say things like, “I know I’m gay, but what if I’m faking it?” That’s not exploration, that’s OCD.

Anderson says it’s essential to validate the natural complexity of identity while helping clients relate to obsessive doubt in a different way.

These obsessions can affect anyone, whether they identify as straight, gay, bisexual, or any other sexual orientation.

While questioning one's sexual orientation is a normal part of self-discovery, SO-OCD or HOCD takes this questioning to an extreme, causing people suffering from HOCD overwhelming anxiety and intrusive thoughts.

Sexual orientation OCD (SO-OCD) involves fears and doubts about your sexual orientation.

In SO-OCD, the experience is driven by fear, doubt, and a desperate need for certainty.