Expert Help for Obsessive-Compulsive Disorder

Behavioral Wellness Clinic
6-D Ledgebrook Drive
Mansfield Center, CT 06250
Office: (860) 830-7838

Monnica Williams, Ph.D.
Clinical Director

Offering expert treatment for all types of OCD, including sexual obsesions. Our OCD treatment program is typically 20 sessions. We offer twice-weekly sessions and intensive programs. Intensive program can be in person or combined with Skype. State of the art medication management is also an option. Low cost options available. [More.]

Sexual Thoughts in OCD

Sexuality Concerns in Obsessive-Compulsive Disorder (OCD)

Many people with obsessive-compulsive disorder (OCD) have sexual obsessions, or unwanted sexual thoughts. This may include sexual orientation fears, which is sometimes referred to as sexual orientation OCD (SO-OCD) or HOCD. Theses are not the same as fantasies or being homophobic.

Sexual thoughts in OCD may include the following:

  • the obsessive fear of being or becoming LGBTQ
  • intrusive, unwanted mental images of upsetting sexual behaviors
  • the fear that one may become a pedophile
  • the fear of becoming sexually aggressive

The Worst Kind of OCD

Although people with OCD may obsess over any number of concerns, one of the most upsetting types of OCD involves worries about causing sexual harm to a child, sometimes called pedophile OCD or POCD. Although this type of OCD typically receives little attention from the media, the Power to Change recently aired the story of a man whose POCD was so severe he contemplated suicide before he was treated by Dr. Monnica Williams. Hear his story online and learn about OCD treatments from Dr. L. Kevin Chapman. Read his story or watch it now.

OCD Therapy Going Nowhere?

Although any medical doctor can take your blood pressure, only a few can do heart surgery. Likewise, any therapist can help someone who is feeling a bit blue, but only a few can effectively treat OCD. OCD treatment is a type of therapy that requires a specialized protocol called Exposure and Ritual Prevention (ERP or EX/RP). Learn about the Top Mistakes Made by OCD Therapists.

Top Seven Myths About OCD

One stereotype is that people with OCD are neat and tidy to a fault. Actually, nothing could be further from the truth. Although many people with OCD wash because they are concerned about dirt and germs, being tidy is actually not a typical symptom of the disorder. Almost two-thirds of people with OCD are also hoarders... Learn more about the Top Myths about OCD.

Take The OCD Self Test

The OCI-R is a short, reliable, scientific test of common obsessive-compulsive symptoms. This measure was developed by OCD experts. Take our OCD Self Test.

Sexual and Homosexual Worries in OCD

by Monnica T. Williams, Ph.D.

Sexual OCD Symptoms

Obsessions in OCD can take many different forms, including sexual obsessions. Such sexual obsessions may involve homosexual activities or fears about sexual orientation.

Obsessions about sexual orientation differ from an individual who is actually gay because the person with OCD does not generally feel attraction or sexual arousal to members of the same sex. The individual with sexual orientation obsessions fears becoming gay or discovering that he or she was unknowingly gay all along. There is a shortage of research examining sexual orientation obsessions in OCD (SO-OCD), sometimes called HOCD for "homosexual OCD."

Sexual Orientation Obsessions (SO-OCD)

The obsessions in SO-OCD take the form of worry about becoming or being gay, engaging in same-sex sexual behavior, and being ridiculed by others for being gay. This type of OCD is often characterized by excessive doubt. The individual may first experience sexual orientation fears when noticing that a member of the same sex is attractive. The individual then questions why they had the thought and mentally panics, leading to more questioning. These fears are more than just fleeting thoughts; they become powerful obsessions that keep coming back.

In an effort to make the thoughts stop, the individual performs compulsions, which may present as checking for indications of physical arousal when around attractive members of the same sex. Symptoms also include avoidance, such as not watching television shows in which there is an LGBTQ character or avoiding spending time with same sex friends. Conversely, the individual may watch pornography with homosexual characters to determine if it arouses them, and then compare their reactions with heterosexual pornography. Another common compulsion to combat the obsessions is to increase sexual intercourse with a partner in order to reassure the individual that s/he still enjoys sexual activity with someone of the opposite sex. People with sexual orientation obsessions are driven by the fear of losing access to people of the opposite sex and acquiring an attraction to people of the same sex.

It is reported that homosexual obsessions have lifetime rates of about ten percent among treatment-seeking people with OCD. In addition, it appears that more males experience sexual orientation obsessions than females. The lack of a specific diagnostic tool to identify people with this subtype of OCD can cause people to be undiagnosed or misdiagnosed by clinicians that are not experienced in treating people with OCD. Such a therapist may mistakenly believe that the individual is undergoing a sexual identity crisis due to "being in the closet," and this sort of discussion only increases the fear in the individual. Being unable to obtain a proper diagnosis or proper treatment may lead to feelings of hopelessness, despair, and even suicidal ideation. This makes sexual orientation obsessions a particularly worrisome type of OCD. Thus it is vitally important that people with sexual obsessions in OCD be treated by an experienced and effective OCD therapist.

New Research

Sexual Thoughts in OCD

If you have unwanted sexual thoughts, contact Center for Mental Health Disparities to participate in a study so that we can learn more about this important issue.

More Information

Articles about SO-OCD


Gordon, W.M. Sexual obsessions and OCD. Sexual and Relationship Therapy, 17(4), 343-354, 2002.

Grant, J. E., Pinto, A., Gunnip, M., Mancebo, M. C., Eisen, J. L., & Rasmussen, S. A. Sexual obsessions and clinical correlates in adults with obsessive-compulsive disorder. Comprehensive Psychiatry, 47, 325-329, 2006.

Williams, M. Homosexuality Anxiety: A Misunderstood Form of OCD. In Leading-Edge Health Education Issues, L. V. Sebeki, ed., Nova Science Publishers, 2008.

Williams, M. T., Crozier, M., Powers, M. B.: Treatment of Sexual Orientation Obsessions in Obsessive-Compulsive Disorder using Exposure and Ritual Prevention, Clinical Case Studies, 10: 53-66, February 2011.

Williams, M. T., Farris, S.G.: Sexual Orientation Obsessions in Obsessive-Compulsive Disorder: Prevalence and Correlates, Psychiatry Research, 187: 156-159, 2011.