Symptoms of HOCD and How to Treat It


Symptoms of HOCD and How to Treat It

What is Homosexual Obsessive-Compulsive Disorder (HOCD)?

Homosexual Obsessive-Compulsive Disorder (HOCD) is a subtype of Obsessive-Compulsive Disorder (OCD) characterized by unwanted, intrusive thoughts and anxiety regarding one’s sexual orientation. Obsessive-Compulsive Disorder (OCD) is more common than many might think, affecting an estimated 1.2% of U.S. adults in the past year. This condition spans various subtypes, including HOCD, underscoring the importance of understanding and addressing this mental health challenge.

Individuals with HOCD experience a significant amount of distress over the fear of being or becoming a gay person, despite not identifying as homosexual. This condition is more about the fear of a change in sexual preference or identity than the actual orientation of the individual. It’s crucial to understand that these concerns are related to sexual orientation obsessions, a form of obsessions within the spectrum of OCD, rather than any underlying sexual preferences or desires.

Symptoms of Homosexual Obsessive-Compulsive Disorder (HOCD)

If you suspect that you or someone you know has HOCD, there are some HOCD symptoms that you can look out for.

Intrusive Thoughts

Individuals with HOCD are troubled by persistent, unwanted thoughts or intrusive images about being attracted to the same sex. These thoughts can include fears about potential homosexual behavior or doubts about their sexual identity, causing significant distress.

Compulsions to Check

Compulsive behaviors may manifest as checking one’s own body for signs of arousal during encounters with people of the same sex or compulsively engaging in sexual experiences with the opposite sex to confirm their heterosexual orientation. This form of checking is a common compulsion aimed at reducing feelings of anxiety but often exacerbates them.


Avoidance behaviors can include shunning contact with people who might trigger sexual orientation obsessions or avoiding situations that could lead to sexual arousal or romantic relationships with someone of the same sex. This avoidance can significantly impair an individual’s ability to maintain healthy, loving relationships.

Reassurance Seeking

Many seek constant reassurance about their sexual orientation, engage in mental compulsions, or ask others to validate their heterosexual identity. This reassurance-seeking is a vicious cycle that temporarily alleviates anxiety without addressing the underlying issue.

Anxiety and Distress

The cycle of obsessions about sexual identity and the compulsive behaviors aimed at resolving these doubts lead to high levels of anxiety and distress. This can interfere with daily life and significantly impact an individual’s mental health.

Mental Rituals

Mental rituals might involve magical thinking or mental compulsion where the individual believes that certain thoughts or actions can prevent them from living an inauthentic life or becoming a bad person due to their perceived sexual preferences.

Hyper-Analysis of Behavior

Over-analyzing one’s behavior or feelings during encounters with people, eye contact, or the perception of an attractive person of the same sex is common. Individuals may scrutinize every interaction for signs of arousal or romantic interest, fueling doubt about their actual sexuality.

Social Withdrawal

Fear of engaging in homosexual behavior or being perceived as gay can lead individuals to withdraw from social interactions, impacting their ability to form and maintain romantic relationships, whether in a current relationship, a heterosexual relationship, or a potential homosexual relationship.

Explanation of How These Symptoms Affect Individuals

Explanation of How These Symptoms Affect Individuals

HOCD is a form of OCD that affects approximately 2.2% of the population in the United States at some point in their lives. These figures highlight the widespread nature of OCD and its potential to affect individuals’ daily lives and mental well-being over the long term. Here are some specific examples on how HOCD symptoms can affect individuals.

Emotional Toll

The intrusive thoughts, unwanted images, and compulsive behaviors contribute to a significant emotional toll, often leading individuals to question their sexual identity and experience a sexual identity crisis.


HOCD can complicate romantic relationships, with the individual’s preoccupation affecting their commitment and ability to engage in healthy, loving relationships.


The distress associated with HOCD can impede performance in daily life, as the individual may struggle to focus on tasks or engage in meaningful activities.

Quality of Life

The persistent doubts about sexual identity and the impact of compulsive behaviors can severely affect one’s quality of life, leading to a sense of living an inauthentic life and missing out on genuine human connections.

Mental Health Risks

HOCD is a form of mental illness that can increase the risk of developing other mental disorders, such as depression and anxiety, further complicating the individual’s mental health landscape.

Misconceptions about HOCD

Misconceptions about HOCD can lead to misunderstanding and judgment towards individuals who are experiencing it. Understanding these misconceptions is crucial in providing support and empathy to individuals struggling with HOCD.

Misconception 1: HOCD is about homophobia


A common misconception is that HOCD stems from homophobia, but it’s actually related to the anxiety and distress caused by intrusive thoughts about one’s sexual orientation, not a negative view of homosexuality itself.

Misconception 2: Having HOCD means you are in denial about your sexuality


Many individuals with HOCD find themselves asking, ‘How do I know if I’m gay?’ or ‘How to know if I’m gay?’ It’s important to understand that these questions often stem from HOCD’s intrusive thoughts and do not necessarily reflect one’s true sexual orientation.

HOCD involves anxiety over sexual orientation obsessions, not denial of one’s actual sexuality. It’s characterized by a fear of being something other than one’s established sexual preference, leading to significant distress.

How 3: HOCD can change a person’s sexual orientation


This mental disorder does not influence or change an individual’s sexual orientation; it affects how they perceive and feel about their orientation.

Misconception 4: Only straight people can have HOCD


HOCD can affect anyone, regardless of their actual sexual orientation, because it’s the obsessive fear and doubt about one’s orientation that defines the disorder.

Misconception 5: HOCD is easy to diagnose and treat


Diagnosing and treating HOCD can be complex due to its similarities with other OCD subtypes and the sensitive nature of the subject. Effective treatment requires specialized knowledge and approaches by medical professionals.

How HOCD is Diagnosed

How HOCD is Diagnosed

The diagnosis is a meticulous process conducted by medical professionals who assess symptoms, and their impact on the individual’s life, and differentiate them from other forms of mental compulsions or OCD.

With 2.5 million adults or about 1.2% of the U.S. population affected by OCD, understanding and diagnosing subtypes like HOCD is crucial. These numbers illustrate the significant number of individuals coping with OCD’s complexities and the necessity for accurate diagnosis and effective treatment strategies.

Role of Mental Health Professionals in Diagnosis

Mental health professionals are crucial in the diagnosis and treatment of HOCD, providing a treatment program that may include cognitive-behavioral therapy (CBT), specifically Exposure Response Prevention (ERP), which is a standard treatment for OCD. They also explore other treatment options, like acceptance and commitment therapy, to help individuals live according to their values and build healthy, authentic relationships.

At Total Mental Wellness, we’re dedicated to providing comprehensive mental health services tailored to meet your unique needs. Whether you’re searching for “mental health services near me” or seeking a holistic approach to your well-being, our team is here to support you.

If you want to connect with a psychiatrist in Fort Lauderdale, our clinic is home to some of the most compassionate and experienced mental health practitioners in the area. We believe in a holistic mental health strategy that addresses symptoms and the root causes of your challenges, ensuring a balanced path to your wellness. Let Total Mental Wellness be your partner in navigating towards a healthier, more fulfilled life.


HOCD is a challenging and distressing condition that can profoundly affect an individual’s mental health, relationships, and quality of life. Understanding the nature of HOCD, its symptoms, and the misconceptions surrounding it is crucial for effective treatment and support. With the right treatment and support, individuals can manage their symptoms and lead fulfilling lives.


What’s the difference between HOCD and denial?

Denial involves refusing to accept one’s sexual orientation, while HOCD is an anxiety disorder where the fear is not about being in denial but about the obsession with being something one is not.

Does meditation help with HOCD?

Meditation can be a useful tool for managing anxiety and stress associated with HOCD, but it should be used as a complementary strategy alongside professional treatment.

What are the triggers for HOCD?

Triggers for HOCD can vary widely but often include any thoughts, situations, or stimuli that bring one’s sexual orientation into question or provoke anxiety about being homosexual.