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, our Therapists have extensive experience supporting those with SO-OCD. You can learn more about the treatment and services we provide here, or email us here to find out more.


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? Therapists at the Center for the Obsessive Mind use 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 we provide here.


The Center for the Obsessive Mind offers

therapy in several states and internationally.

Learn more about where the staff practices, below.

Pastel skies and a pristine beach in Northern California, one of the areas where The Center for the Obsessive Mind helps people with Panic Disorder.


The Center for the Obsessive Mind’s staff therapists offer online treatment for Sexual Orientation OCD throughout California. Our Clients span from San Francisco down to Southern Orange County and San Diego. Whether you’re in Silicon Valley, Santa Barbara, Beverly Hills or Dana Point, the Center’s staff can support you in your recovery.

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


Staff members at the Center for the Obsessive Mind offer therapy for Sexual Orientation OCD in the state of Utah. Since we provide online treatment, we Therapists at the Center for the Obsessive Mind also offer work 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 The Center for the Obsessive Mind practices psychotherapy for Sexual Orientation OCD in Florida.


Therapists at the Center for the Obsessive Mind also offer treatment for Sexual Orientation OCD online in Florida We see people from all corners of the Sunshine state. Whether you’re from Naples, Orlando, Miami, or Boca Raton, we can provide specialized counseling remotely in your area.

The placid, clear waters of Sand Harbor in Lake Tahoe, one part of Nevada where The Center for the Obsessive Mind offers therapy for Sexual Orientation OCD.


Therapists at the Center for the Obsessive Mind also practice teletherapy in Nevada. So if you’re seeking help in Glenbrook, Incline Village, Reno or Las Vegas, we offer specialized treatment for Sexual Orientation OCD online across the Grand Canyon State.

The Seven Sisters sea cliffs in Sussex, England, one international locale where  The Center for the Obsessive Mind provides counseling.


In addition to all of the locations previously listed, the staff at the Center for the Obsessive Mind offer 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 The Center for the Obsessive Mind 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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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 us and we will happily provide you with more information.