Understanding SO-OCD and HOCD
The journey of self-discovery often involves exploring who you're attracted to. As you reflect on your identity, thoughts about sexual orientation naturally arise, as it plays a significant role in how we perceive ourselves. However, Sexual Orientation OCD (SO-OCD), also known as Homosexual OCD (HOCD), can make this process deeply distressing.
What Is SO-OCD/HOCD?
Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts and compulsive behaviors. Because OCD follows a cyclical pattern, breaking free from its grip can be challenging. There are numerous types of OCD, and HOCD is a subtype of OCD in which individuals experience persistent and distressing doubts about their sexual orientation.
Traditionally, HOCD has referred to heterosexual individuals experiencing obsessive fears about being secretly gay or having attraction to people of the same sex. However, the broader term SO-OCD now encompasses intrusive fears about sexual identity in individuals of all orientations. 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. 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.
Causes of Sexual Orientation and Homosexual OCD
The exact cause of HOCD remains unclear, but genetic and environmental factors likely play a role. A family history of obsessive compulsive tendencies or OCD may increase one’s risk, though having a relative with OCD does not necessarily mean developing the same subtype. OCD manifests based on individual fears and vulnerabilities.
Because HOCD symptoms are rooted in anxiety (though not technically an anxiety disorder), cultural and societal stigma surrounding sexual orientation may contribute to its development. For some, internalized fears about identity create an intense emotional conflict, fueling HOCD thoughts and compulsive behaviors.
Obsessive and Compulsive Tendencies that Arise in Homosexual OCD
SO-OCD and HOCD Obsessions
Obsessions in HOCD are intrusive, irrational, and difficult to control. While everyone’s experience is unique, a person with HOCD may experience one or more of the following obsessions:
Feeling attracted to the opposite sex but fearing a hidden same-sex sexual attraction.
Identifying as lesbian but experiencing fleeting sexual attraction to or sexual thoughts about a man, triggering fears of being straight.
Worrying about the difficulty of coming out to family, despite identifying as straight.
Doubting one's entire identity due to thoughts and images about sexual orientation.
Feeling anxious that unwanted sexual thoughts or sexual attraction means being in denial about one's orientation.
Being in a committed relationship but fearing an undiscovered attraction that could jeopardize it.
Obsessing over finding members of the same sex attractive, leading to extreme self-doubt.
Experiencing unwanted intrusive thoughts or mental images about same-sex attraction, homosexual thoughts, or homosexuality, which provoke distress.
Typical HOCD Compulsions
Compulsions are a physical reaction to the sexual orientation obsessions. Intrusive thoughts that cause a great deal of distress are often viewed as something that must be addressed right away. As a result, compulsions are performed to quickly alleviate the anxiety. There are some commonly seen compulsions, such as:
Reassurance seeking: Continuously asking your loved ones or your partner that you are the orientation that you identify with is a large part of HOCD. This could look like someone asking their partner in a homosexual relationship, "I'm gay, right? And we love each other?" While the reassurance works for a little while, those obsessive thoughts will start to creep back in.
Avoidance behaviors: To mitigate the onset of obsessive thoughts, you may choose to avoid certain situations, such as public outings or watching certain media. For example, heterosexual people may avoid the public places such as the gym out of fear of being attracted to the same sex. It can also take the form of limiting your media exposure, to make sure that you don't come across someone who might trigger sexual intrusive thoughts.
Checking behaviors: Checking behaviors can occur to control arousal to those that you aren't attracted to, or don't want to be attracted to. This could manifest as purposely looking at a photo of a man and checking internally that you don't feel aroused. This could also take the form of mentally reviewing life events, such as past relationships or sexual experiences, to confirm that they happened and that you enjoyed them.
Over-researching: In order to validate your feelings, you might spend an unusual amount of time researching topics related to sexual orientations, trying to prove to yourself that you are actually the orientation that you identify as. Someone with HOCD might begin scrolling through online forums, web articles, or social media.
Compulsive dating: As a method of proving to yourself that you are actually the sexual orientation that you identify with, you might compulsively date people that align with your identified sexuality.
What Treatment Options Are There for SO-OCD/HOCD?
Compulsions occur in this disorder as a way to lessen the anxiety associated with the obsessive thoughts. However, this decrease in anxiety is short-lived, meaning that the cycle is going to inevitably start again. As the cycle continues, the urge to engage in compulsions only strengthens. At this stage in OCD, profession treatment is necessary to get you back to the life that you want to live. Thankfully, HOCD recovery is possible with evidence-based forms of therapy.
Cognitive Behavioral Therapy (CBT), and specifically, exposure with response prevention, is the leading psychological treatment to identify and manage HOCD and SO-OCD symptoms. Most patients will find relief with this treatment, with over 80% of clients experiencing reduced symptoms. Sometimes, clients can go into complete remission from both the obsessions and compulsions.
CBT as HOCD Treatment
Cognitive Behavioral Therapy (CBT) is one of the most effective psychotherapy treatments for OCD, including SO-OCD and HOCD. As an evidence-based therapy, it is grounded in extensive research that continues to evolve. CBT therapy providers regularly review new studies and refine their therapeutic approaches to ensure optimal treatment outcomes.
CBT focuses on the relationship between thoughts, emotions, and behaviors—elements that are deeply interconnected. While thoughts may seem arbitrary, they significantly influence behavior. By identifying and modifying unhelpful thought patterns, people with OCD can create lasting behavioral and emotional changes.
One of the defining features of CBT for OCD treatment is its active, hands-on approach. Clients are not passive participants; instead, they engage in structured exercises both in and outside therapy sessions. The progress made in therapy extends beyond the session, as individuals learn to apply newly developed CBT techniques in real-life situations. This continuous practice helps break the OCD cycle, fostering long-term recovery and relief from distressing symptoms.
Exposure and Response Prevention Therapy (ERP)
Exposure and Response Prevention (ERP), a core Cognitive Behavioral Therapy (CBT) technique, is one of the most effective treatments for obsessive-compulsive disorder (OCD). At its core, ERP helps individuals confront their fears directly, addressing the anxiety and fear that drive OCD symptoms. By gradually exposing individuals to triggering situations in a controlled environment, ERP allows them to develop healthier coping strategies instead of relying on compulsive behaviors.
ERP follows a structured approach. Together with your therapist, you'll create a hierarchy of triggering situations, ranking them from least to most anxiety-provoking. Progressing step by step, you’ll face these situations while resisting compulsions. With repeated exposure, anxiety diminishes, and a sense of mastery develops. By the end of ERP therapy, even previously overwhelming fears become manageable. This hands-on approach empowers you to realize that your worst fears aren’t as frightening as they once seemed.
Mindfulness
Adopted from ancient Eastern spiritual practices, mindfulness is a cornerstone of Cognitive Behavioral Therapy. It helps individuals stay connected to the present moment, often by using the breath as an anchor or engaging in body scanning techniques. This practice fosters a deeper awareness of thoughts and emotions, allowing for a more objective perspective. By creating space between oneself and intrusive thoughts, mindfulness can help reduce symptoms of HOCD, lessen compulsive reactivity, and promote greater acceptance. Over time, this shift in perspective supports healthier thinking patterns and emotional regulation.
Cognitive Restructuring
Obsessions feed off of negative thought patterns that you may experience daily if you struggle with OCD. One of the main techniques implemented in Cognitive Behavioral Therapy is known as cognitive restructuring, which is exactly what it sounds like. In human cognition, we can fall susceptible to distorted thinking, especially when it acts on our greatest fears. Thoughts that you have gotten accustomed to can be causing you harm, and identifying these irrational thinking patterns is the first step taken in cognitive restructuring. The next steps involve challenging their validity, and then replacing these thoughts with rational ones. Decreasing negative thoughts can diminish the fuel for obsessive thinking.
Our Treatment of Sexual Orientation Obsessive-Compulsive Disorder
Expert Care in Treating OCD in Los Angeles
Living with HOCD can be overwhelming, as it persistently challenges your sense of self and identity. Our therapists understand this and strongly believe in the potential for remission through Cognitive Behavioral Therapy.
We prioritize your needs. Our psychologists are highly trained in treating a wide range of mental health disorders, all holding doctoral degrees in clinical psychology. Some also serve as faculty at respected graduate programs nationwide. Committed to staying up to date with the latest research, we use evidence-based approaches to help you achieve lasting mental well-being.
High-Quality and Accessible Treatment
With two offices in Los Angeles, we are ready to support you in making meaningful changes in your life. Our commitment extends across Los Angeles County, from the Westside to the Eastside and everywhere in between. To ensure therapy is as accessible as possible, we offer both in-person and virtual sessions. Whether you live farther from our offices or prefer the convenience of home-based care, CBT Los Angeles is here to help. Together, we’ll create a treatment plan tailored to your needs, guiding you toward lasting progress.
Get Rid of OCD Thoughts Today
Our providers at CBT LA want to assure you that we are currently accepting new clients and are ready to provide you with effective OCD treatment today. The battle with SO-OCD/HOCD, or any form of OCD, can be extremely isolating and leave someone feeling hopeless and debilitated. Those suffering from SO-OCD/HOCD don't have to suffer-- reach out today to schedule a phone consultation with one of our experienced OCD specialists.