Homosexual Anxiety and OCD
"I worry all the time that I might be gay. What is the difference between homosexual anxiety as a symptom of Obsessive-Compulsive Disorder (OCD) and actually being gay? How can I tell if I am really suffering from Obsessive Compulsive Disorder?"
Having intrusive thoughts about homosexuality and doubting one's own sexuality are symptoms that characterize a subtype of Obsessive-Compulsive Disorder, sometimes called homosexual anxiety, Homosexual OCD or "H"-OCD.
This article includes a few guidelines you may want to consider to help you understand the difference between suffering from homosexual anxiety (HOCD) and actually being gay.
Sexuality Concerns in Homosexual Anxiety
Typical symptoms of homosexual anxiety (HOCD):
- Recurrent doubts about one's own sexuality
- Unwanted or intrusive thoughts about being gay
- Inability to get rid of unwanted worries or intrusive thoughts about being gay
- Seeing a member of the same sex causes anxiety and triggers unwanted thoughts about being gay
- Avoidance of members of the same sex for fear of unwanted thoughts or anxiety
- Thoughts or worries about giving off signals that one may be homosexual
- Repeating mundane actions for fear that these actions may have been performed in a "homosexual" way or a way that may signal homosexuality in the person (for example, a male may feel the need to get up from a chair and sit back down in it if he feels that the way he sat in the chair was "feminine," or a male may worry that the way he walks is too "feminine" or signals homosexuality)
- Repeating an action may relieve anxiety, but then the person feels the need to repeat the action (or ritual) again and again to relieve anxiety
- Anxiety over being gay is in opposition to one's own values and desires
- One feels that the thoughts are unacceptable and inappropriate
- Homosexual thoughts are repugnant rather than arousing
Typical characteristics of being gay:
- Having sexual encounters with members of the same sex
- Preferring members of one's own sex for sexual/dating partners or feeling comfortable with both male and female sexual/dating partners
- Homosexual thoughts are pleasant, though a person may be shameful of their sexual orientation or keep it a secret
So, how can I tell the difference between being gay and having Homosexual Anxiety (HOCD)?
Gay people may experience anxiety associated with their sexual orientation. However, these anxieties usually stem more from the social stigma attached to homosexuality and the additional difficulties that homosexuals may encounter in finding dating partners. Gay people may experience enough anxiety about making their sexual preferences known that they may keep their sexuality a secret or avoid dating altogether. However, this anxiety is different from the anxiety that a person with HOCD experiences. Individuals suffering from HOCD have an recurring worry that they might be homosexual and constantly remind and reassure themselves that they are heterosexual. HOCD sufferers may have thoughts that are so unrelenting that they avoid situations where these thoughts are likely to occur, such as situations with high contact with members of the same sex (locker rooms, etc.). Individuals with HOCD often fear that they are homosexual even though they may have dated several people of the opposite sex and feel no attraction towards members of the same sex.
Although sexual orientation develops across a person's lifetime, it is not impossible for a person to experience a sudden change in their orientation. However, most people who are gay report feeling different from their same-sex peers at an early age. Researchers have found childhood gender nonconformity to be the largest predictor of homosexuality in adulthood. People who are gay are much more likely to have preferred opposite-sex activities and playmates as children. This is not usually the case for people with HOCD.
What can I do about Homosexual Anxiety?
HOCD responds to the same treatments as any other type of OCD: medication and cognitive-behavioral therapy. The most important part of good treatment is first finding a clinician who will properly diagnose the problem. There is little in the research literature specifically about HOCD, although sexual obsessions are a well-documented symptom of OCD. Therefore, therapists without much experience treating OCD may not recognize HOCD as a true anxiety disorder. Some may suggest psychodynamic treatment, i.e. "talk" or "insight" therapy, to help the patient "come to grips" with his sexuality. This will not help a person with OCD and may make the symptoms worse. The HOCD sufferer needs behavior therapy, which teaches the person how to deal with and successfully diminish obsessions, and often SSRI medications (such as Prozac, Luvox, and Zoloft). More about treatments for OCD...
Where can I learn more about Homosexual Anxiety (HOCD)?
Useful articles about HOCD include I'm Gay and You're Not: Understanding Homosexuality Fears and Homosexuality Anxiety.