Homosexual obsessive-compulsive disorder (HOCD) is a sexual orientation-obsessive-compulsive disorder (SO-OCD). People with SO-OCD may have anxieties relating to their sexual orientation.

It is important to note that HOCD is not a condition that the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition recognizes.

A person with HOCD may have anxiety about experiencing same-sex attraction, even if they do not experience this.

Because HOCD is a type of SO-OCD, some people may use the term to refer to situations wherein people who are not heterosexual experience fears about their sexual orientation.

This article will cover what HOCD is. It will also look at the causes, symptoms, and treatment options associated with SO-OCD.

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HOCD is a form of OCD. OCD is a mental health condition that can cause a person to have intrusive and reoccurring thoughts and images, as well as feel compelled to repeat specific behaviors.

A person who has OCD may feel extreme distress or upset due to these repeated thoughts or compulsions. However, they may be unable to prevent them from occurring.

A person experiencing SO-OCD may find that they are unable to prevent certain thoughts or behaviors that focus on their sexuality.

With this condition, a person who is heterosexual may have fears that they are attracted the members of the same sex.

However, it is important to note that this form of OCD is not limited to those who are heterosexual. A person who experiences same-sex attraction can have intrusive thoughts that cause them to fear that they are in denial about being heterosexual.

These thoughts can be distressing, as a person’s sexual orientation can be an important part of their identity.

Those who experience this form of OCD are typically concerned about losing their identity and living an inauthentic life. It does not mean that they have negative views toward those who have sexual orientations that differ from their own.

A study from 2015 found that 11.9% of people who seek treatment for OCD experience HOCD.

A person with SO-OCD may fear that:

  • They have, or will have, a different sexual orientation.
  • Others will see them as having a different sexual orientation.
  • Any relationship problems are a sign that they have a different sexual orientation.
  • They are in denial about their sexual orientation.
  • They will lose their identity.
  • Any difficulties in performing sexually are due to having a different sexual orientation.
  • Their intrusive thoughts will interfere with their sexual activities and performance.

As a result, a person may develop compulsive behaviors in an attempt to reassure themselves that they do not have a different sexual orientation than the one they identify as having.

Mental compulsive behaviors

Mental compulsive behaviors can include:

  • overanalyzing whether or not the person said or did something that others could perceive as heterosexual or homosexual
  • ruminating over previous sexual experiences to reassure themselves of their sexual orientation
  • an inability to stop thinking about their feared sexual orientation, despite finding it distressing
  • ruminating over imaginary scenarios to see if they would enjoy them
  • attempting to reassure themselves that they have their desired sexual orientation

Physical compulsive behaviors

Physical compulsive thoughts and behaviors include:

  • avoiding talking about, or engaging in, activities that the person sees as different from their sexual orientation
  • looking at pornographic images that are different from their sexual orientation to see whether or not they find them arousing
  • asking others for reassurance
  • monitoring their physiological reactions to people of the same or other sexes

SO-OCD and arousal

A person with SO-OCD and HOCD may check their body to see how it responds to the intrusive thoughts and unwanted images.

According to Mind UK, having sexual intrusive thoughts and unwanted images may cause a person to constantly check their genitals for signs of arousal.

As a result, this can increase blood flow and actually cause physical arousal. This can then lead to the person fearing that they find the intrusive thoughts and images arousing.

HOCD and SO-OCD can have a severe and debilitating effect on a person’s life. For example, these conditions can:

Affect day-to-day life

A person may find it hard to concentrate on other activities besides those that relate to their sexual orientation.

The compulsions can take up a lot of time, and the person may avoid certain situations to avoid triggering the SO-OCD.

Impact relationships

A person with SO-OCD may have anxiety regarding social interaction, worrying that they may do or say something that is seen as contradictory to their sexual orientation.

Additionally, people may feel that they have to hide their fears from their friends and family.

HOCD and SO-OCD can also inhibit a person’s ability to have romantic or sexual relationships due to conflict and anxiety surrounding their sexual orientation.

The Anxiety and Depression Association of America note that having these thoughts and fears does not mean that a person wants to act on them. In fact, the opposite is true.

The reason that people continue to have fears about their sexual orientation is that they put a lot of effort into fighting them. This is due to the thoughts being at odds with who they are.

One 2015 study found that males with HOCD who engaged in sexual activity with those of the same sex did not enjoy it.

According to the National Institute of Mental Health (NIMH), OCD may occur due to the following:


A person who has a parent or sibling with OCD is more likely to develop it themselves.

This chance is higher if the person’s parent or sibling developed OCD as a child or teenager.


There may be a link between childhood trauma and a person developing OCD. However, the NIMH also note that this relationship needs further investigation.

Brain structure

There is a possible link between irregularities in certain areas of the brain and OCD. However, this potential connection is not yet clear.

A psychiatrist can help treat SO-OCD. They may do so using antidepressants and psychotherapy.

Learn more about treatment options for intrusive thoughts here.

Types of psychotherapy that can help treat SO-OCD include cognitive behavioral therapy (CBT) and exposure and response prevention (EX/RP).

CBT is a form of therapy that involves changing a person’s pattern of thinking or behavior. CBT can involve discussing distressing patterns of thinking and talking with a therapist about how to adjust them in a healthful way.

EX/RP involves a therapist exposing a person to what triggers their OCD, then helping them make the decision to not respond to it.

Learn more about some mental health resources available here.

A person who thinks that they may have SO-OCD can see a psychiatrist.

The psychiatrist may ask the person if they have any intrusive thoughts about their sexuality and if they feel compelled to enact specific patterns of behavior to calm themselves down.

Anyone who has distressing thoughts regarding their sexual orientation should speak with a doctor, especially if the thoughts are causing stress, leading to anxiety, or affecting their daily life.

The doctor will be able to recommend a treatment option that will suit the person.

A person should seek immediate medical help if they have any thoughts of harming themselves.

It is possible to overcome SO-OCD. However, some people may continue to experience symptoms.

Treatment can help people learn how to manage these symptoms.

HOCD and SO-OCD are types of OCD that cause a person to fixate on their sexual orientation. These conditions can cause extreme stress and upset for a person who experiences symptoms.

A person who feels distressed regarding their sexual orientation should speak with a doctor or therapist.

There are a variety of treatment options available to help people manage their symptoms.