Sexual Orientation OCD


SO-OCD used to be called HOCD or Homosexual OCD. This heteronormative title became more inclusive to account for anxiety and extreme doubt about sexuality for people who are gay, straight, bisexual, pansexual, etc. Many with SO-OCD do fear they are gay and in denial. However, this is merely a reflection of the central fear common to those with SO-OCD: that they are being disingenuous about their identity. It is worth noting that most people with this form of OCD do not believe there is anything wrong with being gay, lesbian, bisexual, etc. Sexual Orientation OCD has nothing to do with homophobia or bigotry.


How do you know if you have OCD? Only a licensed practitioner can perform an official assessment and provide a diagnosis. That said, the symptoms of OCD include the presence of obsessions and compulsions that take up a significant amount of time, cause distress and impair social, occupational and other important areas of functioning.


Obsessions are intrusive, upsetting, repetitive, distressing thoughts, images and urges. In SO-OCD, obsessions can include thoughts like:

  • What if I’m secretly straight/gay/bi and just can’t admit it to myself? What if I’m in denial?
  • If I don’t figure this out, I could I live an inauthentic life! I could be living a lie!
  • What if I hurt future partners and children when I realize I’m identified with the wrong orientation?

You can learn more about obsessions and OCD in general here.


Compulsions are behaviors that individuals do in order to get rid of the anxiety, doubt, distress, disgust and discomfort that often result from obsessions. A person might do any number of things compulsively. They might wash, check, avoid, seek reassurance, analyze thoughts and more. In SO-OCD, compulsions can look like:

  • Checking and ruminating about physical sensations – like feelings in the groinal region
  • Avoiding contact with a gender that you’re concerned you might be secretly attracted to
  • Confessing thoughts to a partner so that you are not fearful of lying to them about the fact that you could realize that you are attracted to a different gender at some point

You can learn more about compulsions here.



We approach the treatment of every subtype of OCD in the same way, with Exposure and Response Prevention (ERP). This involves facing the things that trigger thoughts and feelings without capitulating to compulsions. For instance, someone who identifies as straight who is afraid they might know they’re gay “deep down,” could put up rainbow flags as an exposure. In response to this, the goal would be to drop compulsions, that is to notice and disengage from rumination, checking arousal, reassurance seeking, avoidance, etc.

The ultimate goals of ERP for SO-OCD are to:

  • allow for the presence of doubt thoughts about one’s sexuality
  • make space for distress
  • accept that one cannot know their sexual orientation with absolute certainty

We want to be careful not to focus too much on the content of OCD as the thoughts themselves are unimportant. Still, there are some common challenges and roadblocks that people with this subtype face. ⁠If you’re interested in support for this subtype, Lauren has extensive experience supporting those with SO-OCD. You can learn more about the treatment and services she provides here, or email Lauren here to find out more about working with Lauren.


While ERP is considered the gold-standard treatment for OCD, Acceptance and Commitment Therapy (ACT) is also an evidence-based treatment for OCD that can be used in conjunction with ERP. ACT draws upon mindfulness principles in order to support people in non-judgmentally witnessing and accepting their thoughts and feelings. By supporting this objective view of these internal experiences, ACT helps people to accept thoughts and feelings while they take actions based on what matters most to them. You can learn more about ACT here.

General Mindfulness as well as Meditation are also helpful approaches that support recovery from SO-OCD. Given that SO-OCD is a type of Pure Obsessional OCD, learning how to deal with mental compulsions is key to treatment. Meditation can support people in disengaging from mental compulsions. Mindfulness can support individuals to peacefully coexist with thoughts and feelings.


Are you or a loved one struggling with excessive doubt about your sexuality? Lauren uses Cognitive Behavioral Therapy, Exposure and Response Prevention and Acceptance and Commitment Therapy to support those with Sexual Orientation OCD. You can learn more about the treatments and services she provides here.


Lauren is a licensed psychotherapist in

several states. Learn more about where

Lauren sees Clients, below.

Pastel skies and a pristine beach in Northern California, one of the areas where Lauren helps people with Panic Disorder.


When she is doing work face to face, Lauren does in-person therapy in Newport Beach. She also provides online treatment for Sexual Orientation OCD throughout California. Her Clients span from San Francisco down to Southern Orange County and San Diego.

The red rock spires of Bryce Canyon in Utah, one of the states where Lauren offers counseling for Sexual Orientation OCD.


Lauren provides therapy for Sexual Orientation OCD in the state of Utah. Since she provides online treatment, she works with people who live in different areas of the Beehive State – from Salt Lake City and its suburbs, like West Jordan, Syracuse, Highland and Riverton, to Park City and St. George.

Clear turquoise waters in the Keys, one of the places where Lauren practices psychotherapy for Sexual Orientation OCD in Florida.


Lauren also offers treatment for Sexual Orientation OCD online in Florida, and sees people from all corners of the Sunshine state. Whether you’re from Naples, Orlando, Miami, or Boca Raton, Lauren can provide specialized counseling remotely in your area.

The iconic red rock and lush greenery of Sedona, one part of Arizona where Lauren offers therapy for Sexual Orientation OCD.


Lauren also practices teletherapy in Arizona. If you’re seeking help in Phoenix, Sedona, Scottsdale or Tucson, Lauren offers specialized treatment for Sexual Orientation OCD online across the Grand Canyon State.

The lavender fields of Provence, France, one international locale where  Lauren provides counseling.


In addition to all of the locations previously listed, Lauren offers teletherapy for Sexual Orientation OCD to a number of countries internationally.

Cozy couch and computer: all you need for teletherapy and what your treatment with Lauren could look like.


Online therapy isn’t right for everyone. An assessment must be done to determine if online therapy is appropriate for your needs. You can reach out here to learn more.


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For more information about working with Lauren

call 310-824-5200 ext. 4 to speak with Client  

Coordinator Lisa O’Reilly at the 

OCD Center of Los Angeles

310-824-5200 ext. 17

1151 Dove St., Ste. 295
Newport Beach, CA 92660

©2021 by Lauren McMeikan Rosen, LMFT.

Disclaimer: The information contained on this website is intended for informational and education purposes only and is not meant to be a replacement for therapy. If you are interested in treatment, you can email me and I will happily provide you with more information