People with HOCD often question their type of sexual liking and preferences for being a guy. Even if their past relationships and attractions indicate they are heterosexual, but intrusive thoughts about being turned gay have captured their minds.
Before thriving on HOCD, sexual identity might not have been a concern, but OCD thrives on doubt. Just as someone has anxiety about health, being sick, or someone with OCD fears germs or contamination. HOCD causes obsessive questioning of sexuality, even if there is no real reason to.
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Common Behaviors in HOCD
A person who is experiencing such thoughts might be involved in behaviors such as:
Check their feelings when they see someone of the same sex
Watch movies to test their reactions
Remembering past interactions to find signs of being gay.
The condition might be worsening if they keep thinking and reassuring themselves like that.
What is HOCD?
HOCD, or homosexual obsessive-compulsive disorder, is a type of OCD where a person experiences intrusive thoughts about their sexual orientation. It is not about questioning sexuality, but it is about obsessive doubts and the need for certainty.
If someone has been heterosexual all their life, they remain heterosexual, but HOCD makes them doubt it. These thoughts are ego-dystonic, which means they conflict with true identity and values, which further cause distress and anxiety.
Psychologists refer to this condition as sexual orientation (SO-OCD) because it affects people of all orientations, and not just heterosexual. Research shows that about 8% of persons with OCD have obsessions related to sexual orientation. SO-OCD is about the need for certainty, not actual changes in orientation.
Symptoms of HOCD and SO-OCD
There are two major symptoms of HOCD that fall into the category: obsessions and compulsions. It is necessary to know these symptoms as a first step in recovery.
Obsessions
Intrusive thoughts or fears that become difficult to ignore are obsessions. In SO-OCD, these thoughts often focus on doubts about sexual orientation, such as:
Fears, like “if I have turned to something which I was not”
“Why am I attracted to someone who is the same gender as me?”
Finding out about past experiences as proof of sexual orientation.
Fear of acting on unwanted thoughts or discovering a different orientation.
There is something attractive about a person of the same sex, and taking it as evidence of being gay.
Focus on fleeting physical sensations like groinal response and seeing them as a confirmation of sexual orientation.
The Groinal Response
Groinal response HOCD can be called a physical response in the genital areas when seeing something about sex, or thinking about it. This can occur in response to intrusive thoughts. Individuals with HOCD often misinterpret this sensation as a sign of sexual attraction, which intensifies anxiety. However, the groinal response is simply a physical reaction that can happen for many reasons and does not indicate actual sexual attraction to someone.
Compulsions
Compulsions are behaviors or mental acts that are used to decrease anxiety related to HOCD. They can be covert (mental) and overt (visible).
Covert (Mental) Compulsions
Reviewing past relationships in mind to reassure oneself.
Bring to mind such scenarios with people of the same or opposite sex to test feelings of attraction.
Remembering and analyzing childhood memories for signs of sexual orientation.
Overt (Visible) Compulsions
Watching adult movies to check for arousal.
Looking for reassurances from others about sexual orientation.
Avoiding LGBTQ+ media, same-sex spaces, or anything that is associated with the feared orientation.
Although compulsions provide relief temporarily, but ultimately reinforce the OCD cycle, and intrusive thoughts make it harder to break.
HOCD vs. Being Gay
HOCD refers to the intrusive thoughts and is related to OCD. While being gay is something else, which involves enjoying and wanting romantic relationships with the same gender.
If someone has HOCD, their groinal response indicates that. Their thoughts are about being gay, but not their actions. On the other hand, a man who is gay, his actions and thoughts show that they are gay, they wants, desires, and enjoys romantic relationships with the same sex.
The Spotlight Effect in HOCD
The spotlight effect comes when the brain becomes primed to look for signs of something feared. In HOCD, this causes a person to look for evidence in their behavior or interactions, even when there is no evidence exists. This hyper-vigilant attitude can lead to misinterpretations.
Causes of HOCD
HOCD, like other forms of OCD, has complex origins, including genetic, neurological, and psychological factors.
Genetics
The genetic history of OCD can increase the likelihood of developing these thoughts.
Certain genes might be linked to OCD, but this is still no proof, as research is going on.
Brain Factors
Differences in brain structure can show differences in people with OCD as compared to those without it.
There might be a link between OCD and the brain’s fear centers.
An imbalance in brain chemicals can contribute to OCD. Medicines like SSRIs help to balance those chemicals and treat OCD.
Psychological Factors
There are some complex causes in psychological factors. HOCD, like the other types of OCD are comple,x and no single reason can explain why someone has it.
Anxiety or mood disorders can make it more difficult to manage intrusive thoughts and compulsions. It is necessary to address these issues along with HOCD.
Treatment Options for HOCD
HOCD, or SO-OCD, is highly treatable with evidence-based therapies such as Cognitive Behavioral Therapy (CBT), exposure and response prevention (ERP), and medication.
Psychiatric help
Psychiatrists and therapists specializing in OCD and sexual orientation issues can solve this problem. Cognitive Behavioral Therapy (CBT), particularly exposure and response prevention (ERP), is the recommended treatment for HOCD. Medication can also be prescribed in some cases.
Evidence-Based Treatment
Evidence-based treatment refers to therapeutic approaches that have been thoroughly studied and proven to be effective. For HOCD, the most effective treatments are rooted in CBT, particularly ERP. These therapies have been extensively researched and proven successful in helping individuals with OCD manage their symptoms.
Cognitive Behavioral Therapy (CBT)
CBT is a structured form of therapy that focuses on the interconnectedness of thoughts, feelings, and behaviors. It helps individuals:
Understand thought patterns and how they contribute to HOCD
Develop coping strategies to correct thought processes and relate to thoughts differently
Recognize the cyclical nature of SO-OCD and interrupt the cycle
Challenge cognitive distortions and replace them with realistic thoughts
Understand the nature of fears and challenge the necessity of rituals and compulsions
CBT is a cornerstone of HOCD treatment, providing a structured path to recovery.