If you’ve arrived on this page as you’re frightened of the thoughts you keep getting such as “What if I’m not straight?” or “What if I’m gay and I’ve been lying to myself?”—and you find you keep checking how you feel, replaying memories, or comparing yourself to others—I’m going to help you stand back and explain to you what is happening.
I’ve done this countless times before in sessions with people just like you, and I want to explain what is happening is actually OCD attaching itself to a very personal part of your identity. My job here is to help you see the pattern clearly and show you what helps.
A quick way to picture SO‑OCD
I use this analogy too much but it works; picture your mind as a smoke alarm that goes off when an old toaster keeps burning your bread. The alarm is there to keep you safe, but it doesn’t need to go off all the time as your house doesn’t burn down; it has just become too sensitive. In SO‑OCD, the alarm becomes hypersensitive around sexual‑orientation themes. A stray spark—a face in a video, a memory from school, a bodily sensation—sets it off. You get that stab of anxiety and then do something to check or reassure yourself ( testing whether you are a rice or not, asking your partner, analysing the past). The alarm quietens for a moment… then it comes back louder. Not because your orientation has changed, but because the checking taught the alarm that this topic is dangerous and must be monitored.
What SO‑OCD is (how I explain it to clients)
SO‑OCD (often called HOCD) is obsessive–compulsive disorder where the obsessions centre on sexual orientation (e.g., “What if I’m gay/straight/bi and don’t know it?” “What if I’m living a lie?”). The compulsions are the things you do to feel certain or safer. I find when I am in session with a person for the first time, that they really struggle with the idea that it is OCD, as every part of them has been screaming at them for possibly a very long time, that something is going wrong with how and whom they are attracted to, but see if any of this feels familiar, as this is all OCD;
- Mental checking/analysis: running through memories, comparing crushes, “testing” how a thought makes you feel.
- Reassurance seeking: asking friends/partners, reading forums, watching videos to see if your reaction “proves” anything; that could be watching gay/ straight porn depending on your long standing orientation
- Behavioural tests: looking at specific images to check arousal; avoiding people, places, or media that spike anxiety.
- Body monitoring: scanning for groinal sensations, heart rate, “butterflies,” or not feeling anything when you look at someone you would normally find very attractive .
You might also notice the groinal response—a normal, automatic body reaction to attention, novelty, or anxiety. It’s a body reflex, not a verdict. Sensations are not proof of attraction.
I think one of the main reasons, possibly, that people don’t originally what they’re struggling with is actually OCD is that no one is ever formally diagnosed with SO-OCD or HOCD. I am a psychologist I have never diagnosed anyone with sexual orientation OCD, but that doesn’t mean it’s not real. I see that a lot on Internet and forums where people keep asking if it’s real or not. Yes it is real but it’s not a diagnosis and I will explain that now,
Why you see “SO‑OCD/HOCD” online but not in the DSM‑5
There isn’t a separate diagnosis called “HOCD” in manuals. Clinicians group this under OCD with sexual‑orientation obsessions. The label SO‑OCD persists because it’s practical—people search for it and finally find help. I use both terms so you can recognise your experience and also understand the clinical frame: this is OCD, not a measure of who you are. Knowing that we ( psychologist, psychiatrists and other mental health experts) use manuals and guides to diagnose is helpful, as there is specific guidance to map what you feel onto a condition that we can treat.
What SO‑OCD isn’t: identity exploration
Sexual Orientation OCD is not the same as exploring your identity. Many people, especially when you’re growing up, wonder about their sexual identity that’s part and parcel of becoming a teenager, becoming an adult and that’s fine. What happens in sexual orientation OCD is a series of obsessions and compulsions that someone like myself, a psychologist or psychiatrist, eventually diagnose you with a condition. In this case obsessive compulsive disorder, so to answer any questions people might have about what sexual orientation OCD is and isn’t in terms of identity. One is exploring your identity. The other is a mental health condition.
You can explore your sexual identify without it being pathological; it’s human. Here’s how SO‑OCD usually differs from that healthy exploration:
The feel of it
- SO‑OCD feels urgent, high‑stakes, and terrifying—“I need 100% certainty now or I’ll lose everything.” Relief is short‑lived and tied to a ritual (checking, asking, testing).
- Exploration feels curious or reflective. There may be uncertainty, but it isn’t a crisis. You don’t need to run experiments every hour to keep panic down.
What happens after you “get an answer”
- SO‑OCD: any answer fades quickly. You’re back to square one because the goalposts move (“What if I asked the wrong question?” “What if I felt something and missed it?”).
- Exploration: answers evolve over time but aren’t chased compulsively. There’s room for self‑kindness.
Behavioural pattern
- SO‑OCD is circular: trigger → anxiety → compulsion → brief relief → more doubt.
- Exploration moves you forward: conversations, experiences, values—without endless safety behaviours.
If you recognise the loop and the need for certainty, you’re in SO‑OCD territory. The work isn’t to prove an identity; it’s to change your relationship with doubt so life can widen again.
How to Stop the OCD Loop
All OCD follows a pattern, and SO-OCD is no different,
First there is a trigger, I’ll give an example of how this works below.
- Trigger: a person, a thought, an image, a sensation.
- Appraisal: “This feeling means something about me.”
- Anxiety spike + attention locks on (you start scanning your body or mind).
- Compulsion: testing, comparing, avoiding, asking, ruminating.
- Short relief that rewards the compulsion. Your brain learns: “Great, do that again next time.”
Treatment deliberately breaks the reward for compulsions and teaches your system that you can have a thought or sensation without turning it into a crisis.
Treatments – what helps
CBT with Exposure and Response Prevention (ERP)
This is the gold standard for OCD. We create a graded list of triggers and practise taking them on without doing the usual safety behaviours. That might mean watching a clip that normally sends you into checking while you let the urge to analyse rise and fall on its own. You learn—through experience, not debate—that you can feel doubt and still live by your values.
- Start here when you’re ready: Exposure and Response Prevention (ERP)
- If you prefer to understand the cognitive side first, read: CBT for SO‑OCD
Cognitive work (the “meaning‑making” side of CBT)
We look at beliefs that give OCD extra fuel: “A real relationship would come with constant certainty,” “Any groinal sensation is proof,” or “If I can think it, it must be true.” You’ll learn to notice these patterns and not treat them as facts.
ACT skills (acceptance and defusion)
Acceptance & Commitment Therapy tools help you hold thoughts lightly and keep moving towards what matters (relationships, study, work, creativity), even while uncertainty is present.
Medication (sometimes)
Some people choose an SSRI alongside therapy, especially if anxiety or depression is high. Medication can lower the background noise so ERP is easier to do. It’s a personal decision made with your GP/psychiatrist. I’m a psychologist and in the UK we do not prescribe, but you can have the conversation with your GP if you want to find out more about medication.
What we won’t do: try to prove or disprove your orientation. That’s reassurance, and it feeds the loop. The aim is freedom—being able to have a thought and still live your life.
Two brief examples
- Alex sees an actor on TV and feels a jab of “What if…?” He opens Instagram to “test,” scrolls for an hour, then asks his partner for reassurance. Relief: five minutes. By evening he’s back in the loop.
Treatment shift: Alex practises watching the trigger clip and not opening Instagram or asking. He lets the urge to test rise, peak, and fall. Over a few weeks, the alarm quietens. - Jess has a groinal sensation on a crowded train and panics. She spends the rest of the day replaying interactions to “work out” what it meant.
Treatment shift: Jess learns that sensations don’t mean messages. She notes the sensation, labels it as “body doing body things,” and returns her attention to the present task. The moment passes without a spiral.
What you can try
- Name the loop. When a trigger hits, say: “This is an OCD loop.”
- Delay, don’t debate. Postpone checking/reassurance for 10 minutes. Notice how your anxiety can rise and fall even without ritualising. When I say ritualising, I’m actually talking about the compulsions, the compulsion to do the things to make yourself feel a bit better, such as checking on Google or checking for sexual response; that’s a ritual.
- Pick one compulsion to drop. Start small and consistent.
These little examples that I’ve used to write this article actually come from recognised models of therapy, such as CBT and cognitive behavioural therapy and if you want to read more about them, I recommend starting with CBT for SO‑OCD and then start designing your ERP steps.
You’ll see me use both SO‑OCD and HOCD. SO‑OCD is the more inclusive, accurate term; HOCD is the older, widely searched label.
If you’re new to this, my full overview—HOCD (SO‑OCD): A Clear Guide—pulls everything into one place. And if you’re in immediate crisis or feel unsafe, please seek urgent support via your local emergency services or crisis lines.
