HOCD: Everything You Need to Know About Homosexual OCD
You noticed someone attractive, and now you can't stop asking what it means. You check how you felt. You check again. You take an online quiz and still aren't sure. If a doubt about your sexual orientation won't let go, it could possibly be HOCD.
By Nathan Peterson, LCSW, OCD therapistWhat is HOCD?
HOCD, or homosexual OCD, is a type of obsessive-compulsive disorder where the obsessions are doubts about your sexual orientation. You'll also hear it called gay OCD or sexual orientation OCD (SO-OCD). The compulsions are whatever you do to try to be sure, like checking your reactions, testing yourself, reviewing memories, or asking for reassurance.
HOCD can happen to people of any orientation. A straight person might fear being gay, and a gay person might fear being straight. The pattern is the same.
What the fear is about
The fear in HOCD usually isn't that being gay is bad. It's the uncertainty. OCD grabs onto the question "what if I'm not who I think I am?" and demands proof, and your orientation isn't something you can prove with 100 percent certainty.
That's why checking never settles it. I know, logically, one more check seems like it should work. It won't. OCD always has one more "but what if."
HOCD symptoms
Obsessions
- Intrusive thoughts or images about being attracted to the same (or opposite) sex
- Doubting your orientation after noticing someone attractive
- Worry that you've been "in denial" your whole life
- Fear that your relationship is a lie
- Feeling like any reaction in your body is proof
Compulsions
- Checking how you feel when you see someone, over and over
- "Testing" yourself by looking at people, photos, or porn
- Checking your body for arousal, sometimes called a groinal response
- Reviewing past relationships, crushes, or memories for clues
- Asking friends or a partner if they think you're gay or straight
- Taking online "am I gay" quizzes or searching for answers
- Avoiding same-sex friends, locker rooms, shows, or certain topics
For the full checklist, see HOCD symptoms. A therapist who treats OCD can tell you for sure, and the free OCD test is a quick place to start.
HOCD vs. questioning your orientation
Questioning your orientation is normal, and it's often part of figuring yourself out. It can be confusing, but it usually comes with some curiosity, or even relief.
HOCD feels different. It feels like dread. It comes with checking, testing, and needing an answer right now, and every answer only lasts a few minutes. It's not about which answer is right. It's about needing to be certain.
What causes HOCD?
HOCD has the same causes as any other type of OCD. The exact cause isn't known, but genetics and brain differences seem to play a part, and stress can make symptoms flare. OCD tends to pick topics that matter to you and that you can't prove with certainty. Sexual orientation fits both. For more on why, see why OCD picks sexual orientation.
What keeps it going is easier to see. Every check or reassurance brings a minute of relief, and your brain learns that checking is how you stay safe. So the next time the doubt shows up, the urge to check is stronger.
How HOCD is treated
The treatment with the most research behind it for OCD is exposure and response prevention, or ERP. It's a type of CBT made for OCD. In ERP you face the doubt on purpose and skip the checking. That might mean watching a show with a same-sex couple without checking how you feel, or saying "maybe I'm gay, maybe I'm not" and going on with your day. For more exposure ideas, see gay OCD in everyday life.
The goal isn't to prove your orientation one way or the other. It's to stop needing an answer before you can live your life.
Medications called SSRIs are often prescribed for OCD, sometimes alongside ERP. That's a conversation to have with your doctor or psychiatrist.
Next time the doubt shows up, try "maybe, maybe not," and skip the check. The doubt can come along while you get on with your day. (Your brain will want to finish the check. Let it want to.)
If you want help building the whole plan, that's what Master Your OCD is for.
Common questions about HOCD
What does HOCD stand for?
HOCD is short for homosexual OCD. It's also called gay OCD or sexual orientation OCD (SO-OCD). It's a common theme of OCD, not its own diagnosis.
Can straight, gay, or bi people have HOCD?
Yes. HOCD can happen to people of any orientation. A straight person might fear being gay, and a gay person might fear being straight.
Does having HOCD mean I'm gay?
Having HOCD doesn't tell you anything about your orientation either way. It means your brain has latched onto the question and is demanding an answer. Treatment isn't about finding that answer. It's about not needing one.
Can HOCD be treated?
Yes. Exposure and response prevention (ERP) is the main treatment. The thoughts may still pop up sometimes. The difference is you stop checking, testing, and asking, and the thoughts lose their grip.
