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Sexual Orientation OCD

Sexual Orientation OCD (SO-OCD) is a subtype of obsessive-compulsive disorder (OCD) that involves distressing and intrusive thoughts related to one's sexual orientation.

What is Sexual Orientation OCD?

Sexual Orientation OCD (SO-OCD), previously known as Homosexual OCD (H-OCD), is a subtype of obsessive-compulsive disorder (OCD) that involves distressing and intrusive thoughts related to one’s sexual orientation. Individuals with SO-OCD experience obsessive doubts and fears about their sexual identity, which can lead to significant anxiety and distress. Contrary to actual sexual orientation, these intrusive thoughts may involve fears of being attracted to a gender that goes against an individual’s established sexual identity.

Common themes in SO-OCD may include concerns about being homosexual, even if the person identifies as heterosexual, or fears of being heterosexual when identifying as homosexual. The intrusive thoughts often involve questioning one’s true sexual orientation, leading to internal conflicts and heightened anxiety.

Compulsions in SO-OCD typically manifest as mental rituals or reassurance-seeking behaviors. Individuals might engage in excessive self-analysis, seek reassurance from others about their sexual orientation, or perform mental rituals to neutralize distressing thoughts. Despite these compulsions, the doubts persist, and the anxiety associated with the uncertainty can be overwhelming.

It’s important to note that SO-OCD doesn’t reflect an individual’s genuine sexual orientation but rather the presence of unwanted intrusive thoughts.

Treatment for Sexual Orientation OCD

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) combined with Exposure and Response Prevention (ERP) is a highly effective approach for treating Sexual Orientation OCD (SO-OCD), helping individuals alleviate distressing doubts and obsessions related to their sexual orientation. At Light On Anxiety, our specialized therapists offer compassionate and evidence-based care tailored to the unique needs of individuals struggling with SO-OCD.

In CBT sessions, clients learn to:

  • Identify and challenge maladaptive thought patterns and beliefs related to their sexual orientation.
  • Develop coping strategies to manage anxiety and distress.
  • Gradually confront and tolerate uncertainty through ERP exercises.

ERP involves exposing oneself to feared situations or thoughts related to sexual orientation while refraining from engaging in compulsive behaviors or seeking reassurance. By learning to tolerate uncertainty and resist the urge to compulsively check or seek reassurance, individuals can reduce their symptoms of SO-OCD.


At Light On Anxiety, our team of psychiatric providers collaborates closely with clients to assess their unique needs and develop personalized medication regimens. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to target symptoms of anxiety and depression associated with SO-OCD. Our approach to medication management prioritizes safety, efficacy, and collaboration with clients to ensure they receive the most appropriate treatment for their symptoms while minimizing potential side effects.

Integrating CBT + Medication

At Light On Anxiety, we offer integrated treatment plans that address both the psychological and physiological aspects of the disorder. Our therapists and psychiatric providers work closely together with clients to tailor treatment plans to their individual needs and preferences.

  • CBT and ERP help individuals develop coping skills, challenge negative thoughts, and confront their fears.
  • Medication management targets symptoms of anxiety and depression, providing additional support and relief.

Through this combined approach, we empower clients to overcome their SO-OCD and improve their quality of life.

Your Unique Path to Freedom From Sexual Orientation OCD 

Our goal is to create a treatment plan that aligns with your needs and preferences, recognizing that each individual’s journey is unique.

What are the symptoms of Sexual Orientation OCD?

Common symptoms of Sexual Orientation OCD (SO-OCD) include:

Persistent and unwanted thoughts about one’s sexual orientation, often contrary to their established identity.
Intense doubts about one’s true sexual orientation, despite having a clear understanding of their identity prior to the onset of OCD symptoms.
Constantly seeking reassurance from oneself or others to alleviate the anxiety associated with doubts about sexual orientation.
Engaging in mental rituals, such as analyzing one’s past or current attractions, to gain certainty about their sexual orientation.
Avoiding situations or people that may trigger the distressing thoughts or uncertainty about one’s sexual orientation.

Engaging in compulsive behaviors, including repetitive actions or rituals, as an attempt to neutralize the anxiety associated with the intrusive thoughts.

SO-OCD can significantly impact an individual’s daily functioning, causing distress, anxiety, and disruption in personal relationships or professional life.

FAQs about Sexual Orientation OCD

To control compulsions related to Sexual Orientation OCD (SO-OCD), consider practicing mindfulness and delaying engagement in rituals to build tolerance to the associated anxiety. Incorporate exposure and response prevention (ERP) techniques, gradually facing triggering situations without giving in to compulsive behaviors. Seek support from mental health professionals experienced in treating OCD, practice self-compassion, and develop healthier coping mechanisms to effectively manage and reduce the impact of SO-OCD compulsions.

Sexual Orientation OCD (SO-OCD) involves themes such as “false attraction,” where individuals grapple with intrusive thoughts about being attracted to a gender conflicting with their genuine sexual orientation. This specific aspect of SO-OCD encompasses distressing fears, often manifesting as unwanted mental images or doubts regarding the authenticity of one’s sexual identity. It is crucial to distinguish these intrusive thoughts from an individual’s true sexual orientation.

Sexual Orientation OCD (SO-OCD) is not uncommon, and it is considered one of the subtypes of obsessive-compulsive disorder (OCD). While precise prevalence rates can vary, OCD, including its various subtypes, is estimated to affect around 1-3% of the global population.

Yes, Sexual Orientation OCD (SO-OCD) is a recognized and real subtype of obsessive-compulsive disorder (OCD).

More About Treatment for Anxiety

What is CBT & ERP for OCD?

Light On Anxiety CEO Dr Debra Kissen describes how CBT & ERP helps clients move past OCD and other anxiety disorders.

Learn more about how we can create a custom individual treatment plan to fit your goals.

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