In my practice, I sometimes encounter men who are so obsessively worried they may be gay or bisexual that it takes up such a significant amount of their daily life and thoughts and causes them nearly crippling anxiety. Sometimes they truly are gay or bisexual, and sometimes not at all.
Such a man constantly may think about if he is walking is too “girly,” or that he may appear gay if he crosses his legs at the knee like a woman. He may even avoid being alone with other men for fear of being attracted to them. He very well could be coping with homosexual obsessive compulsive disorder (HOCD), similar to obsessive compulsive disorder (OCD) but with the added worry of sexual orientation.
HOCD, also known as sexual orientation OCD, has not yet been recognized in the Diagnostic and Statistical Manual of Mental Disorders as a disorder, however, it does exist in both men and women. In this article, I will focus more on men dealing with HOCD.
In my clinical experience working with HOCD men, they find themselves obsessively looking at porn (gay or straight) to see if it sexually excites them. They also constantly may check out others’ reactions to their gestures or conversation to see if they get strange looks or signals that could imply homophobia. Sometimes, they even may go to extreme lengths to prove they are not gay or bisexual by having sex with men.
No matter what actions they take to disprove their sexual orientation, they will continue to live with anxiety-driven OCD. Doubt is their constant companion, and they show up in my office desperate for answers. They want the suffering and confusion to end.
Here are four questions I ask my clients to help them distinguish among gay, bisexual and straight:
- Do you recall having sexual and romantic feelings for another boy during your childhood?
- HOCD men always say no, while straight men with OCD never say yes.
- How do you feel about gay people?
- Closeted gay and bisexual men often are virulently anti-gay, where HOCD men are not.
- At the beach, whom do you look at most?
- Gay men will say women are in their way when trying to look at men, while straight men will only look at women. Bisexual men will say one or the other or both. The HOCD man is checking himself to determine his level of arousal while looking at men and women.
- Whom do you want to come home to?
- I call this their “home culture.” Gay men will say a man. Bisexual man will say one or the other or both. HOCD men will say a woman.
Of course, the whole question of sexual identity is exacerbated by societal pressures. Influenced by the heated atmosphere around sexual politics, and even the amount of media coverage around LGBTQ issues, some gays argue that in the coming-out process they went through much of the same confusion, and therefore believe that the HOCD person is simply experiencing the same thing.
They are not the same thing.
With HOCD individuals, their confusion will not be resolved by “coming out of the closet” because they are not gay or bisexual.
When I’m working with men experiencing HOCD, I recommend they also see a specialist who has training in OCD interventions. There aren’t a lot of therapists dually trained, however, as the incidence of HOCD continues to increase, we will see more therapists equipped to handle these patients without referrals.
To read my entire article on HOCD, click this link to Psychology Today: www.psychologytoday.com/us/blog/understanding-the-erotic-code/201804/homosexual-obsessive-compulsive-disorder-hocd