HOCD and Intrusive Thoughts

HOCD (homosexual obsessive compulsive disorder) is a subgroup of Obsessive Compulsive Disorder (OCD). It causes relentless questioning of one’s sexual orientation via the intrusive thoughts that are characteristic of OCD. HOCD is also known as Gay OCD or Sexual Orientation OCD (SO-OCD).

The term HOCD is not a recognized scientific or diagnostic name. Instead, it is more of a reference name or “title” that is used within the OCD community. This term defines the mental anguish that comes from experiencing intrusive, unwanted thoughts that you might be gay. If you have HOCD, these thoughts can come so often that, over time, it can become unbearable.

Part of the frustration with HOCD is that, once the intrusive thoughts are triggered, the person’s mind refuses to accept the reality that they have never been attracted to the opposite sex before. They can try to convince themselves that they are content with their straight orientation, but their OCD won’t allow them to do so. Eventually, these thoughts can become intrusive enough to make a person quit a job or leave a relationship because they are so convinced that they have been lying to themselves their entire life.

If you have HOCD, you might:

  • Fear that you have been living in denial of your true orientation.
  • Worry that just the fact that you are questioning your sexual identity means you are gay, because “I wouldn’t wonder about my orientation if I was straight.”
  • Fear losing your “self” and your previous identity.
  • Be concerned that homosexuality is “catching” in the same way that a cold or the flu can be caught.
  • Worry that being around a gay person will trigger your own latent tendencies and cause you to act out.
  • Fear that being unable to perform sexually means you are gay.
  • Think that other people will see you as gay because of a certain mannerism or because of how you dress or act.

HOCD Is All About Intrusive Thoughts

The truth is, HOCD is not about the person’s sexual orientation – it is really about their intrusive thoughts and how they react to those thoughts.

People without OCD will have a random thought and then dismiss it because it has no meaning. Those who have OCD and HOCD, however, attach deep meaning to these random thoughts and often spend countless hours searching for one hundred percent assurance that the thought is or is not true.

These intrusive thoughts don’t go away, either. For someone with OCD, once an intrusive comes into their mind, they cannot dismiss the thought because it sets up a cycle of doubt and questioning that repeats over and over again.

As far as OCD goes, no proven cause has been found for the disorder. And, since there isn’t just one concrete cause for OCD, there also is no exact reason for why someone with OCD will go on to develop HOCD or another subgroup. What we do know is that OCD and its subgroups revolve around whatever it is that the person fears. For example, while some may worry that they are actually gay (HOCD), another may worry that they will hurt themselves or others (Harm OCD).

Help for HOCD

Because there are only a few studies out there on HOCD, many mental health professionals don’t realize this subcategory exists. Therefore, they don’t understand how to properly diagnose and treat it. In many cases, clinicians either miss the diagnosis or they call it “sexual identity confusion” instead of HOCD. But, remember – HOCD is not about sexual identity, it is about the person’s OCD (whether it has been diagnosed or not).

There is a big problem with labeling and treating HOCD as “sexual identity confusion.” It can cause the individual to believe that their misinterpretation of their sexual orientation is actually meaningful and true. For this reason, when seeking help for HOCD, it is extremely important to find a therapist who specializes in treating either OCD or the HOCD subgroup.  

A therapist who is familiar with the condition will also understand that HOCD is not something that can be cured through reasoning and talk therapy because there is no underlying homosexuality to uncover. Instead, treatment for HOCD should involve the same therapies clinicians use when treating classic OCD. These include cognitive behavioral therapy (CBT), exposure and response therapy (ERP), exposure and ritual prevention therapy (EX/RP), and sometimes the short term use of medication to help with depression and anxiety.

We Are Experts In The Treatment of HOCD

If HOCD has left you struggling with relentless questions about your sexual identity, HOCD: Everything You Didn’t Know – A Primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder, a book by Dr. Rosen, Founder and Clinical Director of The Center for Treatment of Anxiety and Mood Disorders will be an indispensable and compassionate guide that will demystify the disorder and offer hope.

In addition to this book, our clinic has therapists who are specially trained to treat OCD, HOCD, and other subgroups of the disorder. For more information or to schedule an appointment, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at 561-496-1094.

10 Comments
  1. Reply
    Davi Martins Carvalho

    My sexuality has always been something solved, now I’m 22, as long as I understand myself, there was never any doubt about it! The beginning of my story was all back there. I had obsessions of all kinds, started at 15 with my foot, because he did not have the arch, that is, my foot was pronated, I was cracked in it, I used orthopedic insoles and everything. I gave problems in my knees, hips and I was 2 years stepping like the batoré! I had a serious knee problem, I thought I had something serious, I had an MRI scan and I only identified that I had “patellar chondropathy”, I spent 3 years trying to solve this problem. I had several episodes of my life where everything stopped because of problems, problems which my family said were imaginary! On my foot I mentioned, I thought I had to have surgery, correct my footstep, I stopped playing sports, I stopped everything in my life! I didn’t play soccer anymore, I slept with tennis Because I believed that the longer I used the insole I would correct my footstep, I was really FRAZED! I believed that I would have the arch of my foot wearing 24-hour insole shoes, my feet would be “PURPLE”, because I lacked circulation! Guys, for you to understand how things work in my life, if I focus on something, my life really stops! Anyway, now I have sexuality, where it all started this year, at 22! I was having anxiety attacks, panic, I went to the psychoanalyst! Getting there, in the analysis with him, I was opening some issues with him, until we got to sexuality issue! I started having erotic dreams with men, something that never happened, I was bringing it for analysis …. until one day he asked me: “what problem would you have if you were homosexual?” …. I was desperate, did not want to show him that I was scared, but inside I was “RASSED”. I had gone to solve my crises in psychoanalysis, but everything got worse, now anyone of the same sex I already look different, something that never happened! I assumed I was bisexual for my family, I broke up with my girlfriend because of that, my life turned into hell guys! By the way, I’m testing myself with gay P to see if I have an erection … it’s very cool. Lately I’ve been staying desperate, i get testan It seems that I test works, and it is real, that I am really bisexual, then I start to get more anxious, I get more lost. These questions have gotten me even at work, I can not stop thinking, is all day, and I need to keep researching, researching, researching, to be sure of my sexual orientation !!!! Help me

  2. Reply
    rachel frampton

    My brother is struggling to identify his sexual orientation. I never knew that there is such a thing as intrusive thought when a person’s mind refuses to accept the reality that they have never been attracted to the opposite sex before. It’s best if we’ll just look for a therapist that can help him figure things out.

  3. Reply
    Luke

    Hood afternoon

    I’m a male I’ve been attracted to girls since I remember. Bit I’ve seen articles saying that sexuality cam change and I’m scared because I don’t want too be gay. I dont hat gay people but the idea of me being gay makes me afraid and i dont want my sexuality too change. Please respond thank you

    • Reply
      Dr. Andrew Rosen

      Hi Luke,

      Please contact us through the contact page to learn more about the options and support available.

  4. Reply
    Guadalupe Ramirez

    My entire life I’ve known I had an attraction to women. I have genuine feelings for girls when I’m around them or if I’m dating I know there’s an attraction. But lately I’m pretty sure I’ve been struggling with HOCD. It all started after a friend came out to me as transgender right in the middle of a mental breakdown for me. Idk what happened but the next day I kept wondering and wondering, “what if I’m also not living my true self” “what if IM trans” “what if I’m gay or bi or something else”. Remember this was all happening in a time of high anxiety for me. I was going through something at the time and I was telling my friend about it, and for some reason he thought it was a good time to tell me his issues too. So then after that day that little voice in my head has never really left. It’s so annoying because this was something I never ever questioned ever. I knew 100% I was straight. I’ve never had an attraction to men and I still don’t. Yet I keep checking to see if I’ve developed one, or if I’ve ever liked men in the past. It’s like my mind just wont sit down and accept my reality. This issue isn’t the only thing my anxiety latches onto, it starts to question other things in my life that I’m 100% sure of. I’m so over it, someone please help

    • Reply
      Dr. Andrew Rosen

      Hi Guadalupe,

      Please contact us through the contact page to learn more about the options and support available.

  5. Reply
    Guadalupe Ramirez

    I just wanna point out that I have nothing against bisexual people or gay people or trans people. In fact I’m a very open support for the LGBT community. I’ve had friends who are part of it. But my sexuality was never a question for me, I knew 100% I was a straight male my entire life. To this day I don’t feel a sexual attraction towards men, but my mind has pounding me with question after question ever since that night my friend came out to me. I’ve even told myself that I wish I was bisexual, so this can be over and I can have my life back. but the thing is I know I’m not, I’ve never had an attraction to men, and I don’t today. But my mind finds every excuse to make me think I am. It does it with everything now, it tries to convince me I’ll get hooked on drugs, or that I won’t be able to control something about me. One time I watched something about murder and my anxiety went on a spiral trying to convince me I’ll kill someone and won’t be able to control it. I’m sad to say that my mind tries to convince me of dark dark things sometimes too, and I’m getting so tired of it.

    • Reply
      Dr. Andrew Rosen

      Hi Guadalupe,

      Please contact us through the contact page to learn more about the options and support available.

  6. Reply
    Matthew Romulus

    My name is Matthew and I am confused on whether if I have HOCD or am I actually gay or bisexual? This all started around the month of February, the question randomly just popped inside my head and I took it into a deeper context. I started to go online and take online quizzes to double check to make sure what’s my sexual orientation. I remember one day I said it too much then my body started to have nerves or butterflies and I thought it might be a sense of attraction because someone told me you feel it in your stomach. I felt it in my stomach but it wasn’t a good feeling because it felt painful. During the quarantine, I’ve been recently calling my brothers to help me not overthink or over analyze everything. I’m also afraid that if I smile at a guy’s butt or smile at a guy shirtless that might mean I’m gay. Usually when I have an erection from a girl, I feel normal. On the other hand, when I got an erection from a guy, I feel afraid. Now all of the sudden, if I see or if my eyes notices a shirtless guy. I feel like my pupils dilate (sometimes it does and sometimes it doesn’t). Or if I look at a guys butt and feel that feeling, it’s anxiety but it feels like attraction because the feeling is so strong. Now if I notice or shirtless man or see an attractive guy my pupil start to dilate. I know that I’ve had crushes on girls in the past. I do not want to be gay?

    • Reply
      Dr. Andrew Rosen

      Hi Matthew,

      Please contact us through the contact page so that we can provide support and answer your questions.

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