Sexual orientation OCD (SO-OCD), sometimes called HOCD, is not the same as the denial of your sexuality. Denial is a psychological defense mechanism, while SO-OCD is a subtype of obsessive-compulsive disorder (OCD) in which people experience intrusive doubts about their sexual orientation, regardless of their actual identity. The two are fundamentally different, though they may appear similar from the outside.
In this article, we’ll explain what SO-OCD is, how it differs from genuine exploration of your identity, why trying to “figure it out” only feeds into the OCD cycle, and how effective treatment can help.
What is sexual orientation OCD (SO-OCD)?
SO-OCD is a subtype of OCD involving intrusive thoughts, feelings, images, sensations, or urges about your sexual orientation and the compulsive need to find certainty. Someone with SO-OCD might fear being gay, straight, or bisexual—regardless of their actual orientation.
- Obsessions: Unwanted, distressing doubts like “What if I’m secretly gay?” or “What if I’m actually straight and lying to myself?”
- Compulsions: Checking reactions to others, mentally reviewing past relationships, researching online, or seeking reassurance from friends.
These cycles create significant anxiety and disrupt daily life. Importantly, the distress comes not from being a specific orientation, but from the uncertainty itself.
Is SO-OCD the same as denial?
No. SO-OCD is not denial.
- Denial is a defense mechanism where someone unconsciously refuses to accept their true identity. It often shows up without constant anxiety or repetitive compulsions.
- SO-OCD involves intrusive thoughts, ongoing doubt, and compulsive behaviors aimed at reducing anxiety. People with SO-OCD often desperately want certainty about their orientation, but compulsions only make the doubt stronger.
In short: denial hides, while OCD obsesses.
SO-OCD vs. questioning your sexuality: What’s the difference?
Here is a look at the key differences between genuine questioning and SO-OCD:
| Genuine questioning | SO-OCD |
| Feels like curiosity or growth | Feels urgent, distressing, repetitive |
| Open-ended reflection | Constant need to be sure |
| Brings clarity over time | Increases confusion over time |
| May seek support to understand identity | Seeks reassurance to eliminate uncertainty |
Why do people with SO-OCD fear they’re “in denial?”
One of the most common obsessions in SO-OCD is the thought: “What if this isn’t OCD at all—what if I’m just in denial?”
This is itself part of the disorder. The brain latches onto doubt and pushes the sufferer to keep questioning.
For example:
- “Maybe my attraction history is fake.”
- “What if I’m secretly lying to myself?”
- “Does this thought mean I’m in denial?”
Each question fuels compulsions like endless self-analysis, checking physical arousal, or repeatedly coming out to oneself. Unfortunately, these compulsions never resolve the doubt—they reinforce it.
When to seek help
You might be experiencing SO-OCD if:
- You feel stuck in an endless cycle of doubt and reassurance.
- You’ve lost interest in things you once enjoyed.
- Your thoughts cause distress and interfere with daily life.
Your best option for seeking help is to consult a mental health professional. An OCD specialist can help you make sense of your experiences and start you on the right treatment.
How OCD treatment can help
If you’re struggling with obsessive thoughts about your identity, know there’s help available. The most effective way to break this cycle is with exposure and response prevention (ERP) therapy. ERP is a specialized form of CBT proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms.
For SO-OCD, your ERP therapist may have you do certain exercises to overcome your fears, such as:
- Watching videos of people of varying sexualities
- Writing a story or imagining a scenario where you identify with a different sexual orientation
- Sitting with the uncertainty & discomfort of never getting a solid answer
These exercises can help you stop seeking an actual “answer” about your sexuality.
Other approaches that may help include:
- Medication (typically SSRIs)
- Mindfulness-based strategies
- Acceptance and commitment therapy (ACT)
These are typically done in combination with ERP therapy, depending on the individual’s needs.
Severe or treatment-resistant SO-OCD may benefit from the following therapies:
- Intensive outpatient programs (IOPs)
- Partial hospital programs (PHPs)
- Residential treatment centers (RTCs)
- Transcranial magnetic stimulation (TMS)
- Deep brain stimulation (DBS)
- Gamma knife radiosurgery (GKRS)
It’s important to understand that OCD treatment isn’t about “labeling” your identity—it targets the cycle of fear and doubt.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
A note on LGBTQIA+ identity and affirming care
Questioning sexual orientation is a valid part of the human experience. That said, if you’re unsure if you’re experiencing SO-OCD or just exploring your sexuality, there are several OCD specialists—some within or affirming of the LGBTQIA+ community—who can help you better understand what you’re going through and guide you towards the right support.
Living with SO-OCD
If you’re struggling with SO-OCD, you’re not alone. Many people with OCD experience obsessions that directly contradict their values or sense of self. The important thing to know is:
- Doubt and uncertainty are the core problems, not your identity itself.
- Effective treatment exists and can help you move forward.
- Working with an OCD specialist is crucial for obtaining the proper support.
Bottom line
SO-OCD creates distressing doubts that feel like denial, but they’re part of the OCD cycle, not a reflection of your true identity. If you’re ready to break from the cycle, reach out to an OCD specialist who can recommend the best treatment for your symptoms.
Key takeaways
- SO-OCD causes intrusive thoughts and anxiety around sexuality, often leading to compulsive checking or reassurance-seeking.
- The fear of being “in denial” is actually a common OCD obsession, not a sign that your thoughts are true.
- Trying to figure it all out only strengthens the OCD loop and keeps you stuck.
- Exposure and response prevention (ERP) therapy helps you break free by learning to tolerate uncertainty.
