Homosexual Obsessive Compulsive Disorder (HOCD)

What if I like people of the same sex? Are my emotional failures due to the fact that I'm actually homosexual? These types of thoughts, when they become recurrent and limiting, define a specific type of disorder.
Homosexual Obsessive Compulsive Disorder (HOCD)

Last update: 01 September, 2022

Homosexual Obsessive Compulsive Disorder (HOCD) defines a situation in which an individual experiences constant doubts about their sexual orientation. In fact, this insecurity and persistent doubt become an obsession capable of altering their relational, personal, and work environment.

Their mind is filled with intrusive ideas and images that further fuel their doubts. It even leads them to perform compulsive behaviors to alleviate their anxiety.

This condition, although it may sound strange, is quite common. It begins between the ages of 18 and 20 and can completely shape the life of the sufferer. For example, they’ll avoid certain situations such as going to the gym, and will experience excessive discomfort when faced with people of the same sex at work.

HOCD is a condition that affects heterosexual men and women who have a fear of being homosexual. It doesn’t mean, however, that they’re homophobic. It’s a psychological condition defined by irrational fear, and there are generally no variables related to social prejudices.

Let’s find out a little more about this type of disorder.

bearded guy

Homosexual obsessive-compulsive disorder: symptoms, causes, and treatment

HOCD can basically be defined as a type of obsessive-compulsive disorder based on an excessive and irrational fear of becoming or being homosexual. Subjects (heterosexuals) experience a series of unwanted and intrusive mental images of homosexual ideas and behaviors.

It may seem contradictory, and, seen from the outside, we may not fully understand why someone should suddenly obsessively question their sexuality. Nevertheless, we need to understand that these types of mental conditions based on obsession and compulsion, such as love or relational OCD, are more complex than we might initially think.

For example, we now know that there are different alterations in brain connectivity. Studies, such as those conducted by the Bellvitge Biomedical Research Institute, Barcelona (Spain), indicate that situations in which an idea suddenly turns into an obsession may be due to a dysfunction in the synchronization of activity between different groups of neurons.

HOCD can be extremely limiting. Research conducted by the psychiatry department of Delhi (India), indicated that 65 percent of the people who suffer from it find it a debilitating condition.

Let’s find out some more about HOCD

What symptoms or manifestations does HOCD present?

The key element that defines this type of psychological condition is the fear of being attracted to something unwanted. As a matter of fact, it could also be suffered by a homosexual person who fears that they are, or might become, heterosexual.

An individual who’s already accepted their sexual orientation, when they’re between the ages of 18 to 25 years old, suddenly experiences a senseless and irrational fear and they find themselves asking: “What if I’ve spent my whole life believing that I’m hetero but I’m actually gay?

Symptoms of HOCD

  • Most of these people have previously accepted and enjoyed their sexuality. In other words, they’ve had satisfactory relationships. However, suddenly, an intrusive thought arises that questions everything. This idea becomes overpowering and obsessive.
  • Their mind won’t stop creating images and producing uncomfortable thoughts. Furthermore, they constantly question their sexual orientation.
  • Obsessive ideas are followed by compulsive behaviors that seek to alleviate their anxiety. Some of them are: dating many people of the opposite sex; establishing compulsive and harmful relationships; seeking the company of people of the other sex even if they’re not to their liking, etc.
  • Compulsive behaviors also appear. For instance, fear of contamination, constant washing, checking, the need to obsessively organize, etc. All of these rituals are aimed at deactivating their unwanted thoughts.
  • Many limit their social life altogether. In addition, their sexual relations are affected by the weight of intrusive ideas and constant doubts.
  • They watch heterosexual pornography to experience arousal. Also, to convince themselves that their sexual orientation is what they’ve always assumed it to be up until now.
  • They continually remind themselves that they don’t experience any type of excitement in the presence of people of the same sex.
  • They act in an over-the-top manner to show that they’re straight.
  • They’re obsessed with their disabling ‘homosexual thoughts’ and replacing them with ‘straight thoughts’.
  • They experience distress if they’re with homosexual people as they fear they might lose control by feeling irrepressibly attracted to them.
  • They’re afraid of ‘catching’ homosexuality if they establish close contact with people who are homosexual.

What are the causes of homosexual OCD?

Homosexual OCD isn’t caused by a repressed sexual identity. It’s basically an anxiety disorder. These are conditions in which the sufferer becomes obsessed with an idea and feels unable to handle that image. In fact, there are different types of OCD and many of them don’t have a specific trigger or cause that explains it.

That said, in homosexual OCD there’s often one common denominator. It’s the fact that sufferers tend to see homosexuality as negative. The most frequent causes are:

  • Irrational ideas about homosexuality. They may think that being homosexual is wrong, thus they develop irrational ideas about it. Some prejudiced ideas are: that homosexuals are promiscuous individuals, that they carry out risky sexual practices, that homosexuality is a disease, etc. They also tend to believe that a heterosexual can’t find a person of the same sex attractive.
  • Having received an education that promotes the rejection of homosexuality. Irrational ideas can be reinforced if the sufferer grew up in a family or culture that explicitly rejects homosexuals.
  • Fear of rejection by their relatives if they turn out to be homosexual. Linked to the previous point, if the individual grew up in an environment where being gay was frowned upon, they may develop an intense fear of not being accepted by their loved ones.
  • Biological and genetic factors. The mechanism by which an idea establishes in the mind of the individual and alters their behavior, as well as their cognitive and emotional approaches, has a neurological origin.
angry woman thinking

How is homosexual obsessive-compulsive disorder treated?

The approach to HOCD will always depend on the particular needs of each patient. In the most serious cases, it’ll be necessary to combine the pharmacological approach (fluoxetine) with the psychotherapeutic one. Thus, the most common and effective approach is:

  • Exposure and response prevention technique. This strategy is part of cognitive-behavioral therapy. It consists of deliberately exposing the sufferer to those ideas that they feed and that intensify their anxiety. The intention is to get them to rationalize every idea, image, and sensation by reducing the emotional and cognitive components to make their thoughts healthier and more integrated. This strategy is best suited for impulse control, obsessions, addictions, etc.

It should be noted that it’s always important to receive specialized help in any type of situation based on obsessive-compulsive thoughts and behaviors. They’re conditions that completely alter the functionality of the sufferer. In addition, they tend to intensify over time and lead to more problems as well as psychological comorbidities.

Fear of being homosexual in adolescence

In adolescence, behaviors similar to obsessions often appear, but they don’t become so. One of them is the fear of being homosexual. However, if it’s ignored, it can worsen.

For this reason, it’s important that adults who constantly interact with adolescents (teachers, parents, caregivers, etc.) are able to detect any signs of this particular fear. As a matter of fact, the young person will probably keep it a secret, because they’re trying to avoid giving any signs that they may be homosexual. They also worry that others will notice their doubts and will interpret them as proof that they are or might be homosexual.

In these cases, psychotherapy is the best intervention to address the fear and prevent it from becoming an obsessive-compulsive disorder.

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  • Bhatia, M. S., & Kaur, J. (2015). Homosexual Obsessive compulsive disorder (HOCD): A rare case report. Journal of Clinical and Diagnostic Research9(1), VD01–VD02. https://doi.org/10.7860/JCDR/2015/10773.5377
  • Pujol J, Blanco L, Maciá D, et al. (2019). Mapping Alterations of the Functional Structure of the Cerebral Cortex in Obsessive–Compulsive Disorder. Cerebral Cortex, 29(11), 4753–4762. https://doi.org/10.1093/cercor/bhz008