Queer Themes in OCD

While OCD has as many manifestations as there are colors in the rainbow, some OCD themes may present more frequently in the LGBTQIA+ community as well as the polyamorous, kink, and other non-traditional relationship communities. The purpose of this article is to identify some interesting trends and unique OCD themes I have noticed in working with these populations.

In my experience, folks in these communities have a greatly increased chance of their OCD latching on to themes involving sexual orientation, gender, and/or relationships. This may be because folks in these communities have an increased awareness of the role that sexuality, gender, and relationships play in their lives, as they may have had to fight for, accept, process, and wrestle with these concepts more than others. Therefore, when the broken alarm system that is OCD creates an urge to scan one’s life for potential problems, folks in these populations may be more predisposed to obsess around these themes.

A little precursor before we jump into some examples: it is completely healthy and even expected for a given individual to struggle at some point in their lives with many of these concepts. When I talk about OCD however, I am describing a situation where an individual finds it so difficult to tolerate fears that they may be concluding something incorrectly that they spend an excessive amount of time and energy trying to achieve certainty, which significantly impacts their daily functioning. This search can include observable actions such as googling, asking friends, or testing if one’s genitals respond to different images, as well as covert compulsions such as mentally reviewing information and engaging in an endless internal debate. If an individual has OCD, the therapeutic goal is to build an ability to identify their best guess and tolerate the uncertainty that it is wrong. For more about the nuances of treatment, check out this and this article.

The following are some themes that folks with OCD that I worked with or know have obsessed over:

Relationship OCD (ROCD): 

Many queer folks face rejection and descrimination from others, including their biological family. Therefore, the people they choose to bring into their lives can carry an extra special importance to them. Sometimes, this can lead to folks feeling extra pressure to choose the right person to be in a relationship with or especially fear losing the person they’ve chosen.

Some folks in queer communities may compulsively respond to this pressure through avoiding intimacy. For example, one trend amongst gay and bi men seems to be an increased likelihood of engaging in flippant sexual encounters either to avoid the risk of intimacy or to compulsively check elements about their sexual orientation. 

Queer folks with ROCD may obsessively ask:

  • How do I know if I’ve found the one?

  • How do I know if my partner will leave me?

  • Is our relationship passionate enough?

  • Am I sexually attracted to my partner enough?

  • How do I know if I’m gay enough, masculine enough, feminine enough, or queer enough for my partner?

  • How do I know if my partner is gay enough, masculine enough, feminine enough, or queer enough for me?

Sexual Orientation OCD

At first, sexuality and gender themed OCDs colloquially fell under a category (not created by psychologists, but by those within the OCD community) called Homosexual OCD (HOCD). Nowadays we understand sexuality to be far more complex than a gay-straight binary and likewise understand that OCD themes can be more nuanced as well. The umbrella these themes fall under is now usually referred to as Sexual Orientation OCD (SO-OCD).  Folks struggling with SO-OCD may obsessively ask:

  • I identify as straight but what if I’m wrong? How do I know if I’m really straight?

  • I identify as gay but what if I’m wrong. How do I know if I’m really gay?

  • I identify as bisexual/pansexual but mostly pursue X gender. What if I’m wrong in determining the “ratio” of my bisexuality/ pansexuality? What if I’m not actually bisexual or pansexual? How do I know if I’m bisexual or pansexual?

  • I identify as (any sexual orientation) but what if I’m wrong. How do I know what to identify as? Which labels describe me best?

Gender OCD (GOCD)

This theme has had somewhat of a rising trend the last few years as more folks learn that one’s gender identity is a choice, which can evoke distress that one’s choice could be “wrong”. While GOCD can come up in someone who has no innate desire to transition or alter their gender but fears that they could be wrong, it can also come up in those who genuinely want to transition and fear that they may make the wrong choice. Folks struggling with GOCD may obsessively ask:

  • I identify as cis-gender, but what if I’m wrong?

  • I identify as transgender, but what if I’m wrong? How do I *know* if I’m trans?

  • Should I take hormones? Should I get surgery?

  • How do I know how much transitioning I want to do? When should I stop transitioning? 

  • How do I know what to identify as? What pronouns should I use?

Pedophilia OCD (POCD)

One harmful and baseless stereotype about queer folks, especially gay men, is that they are malevolent pedophiles. Growing up with these stereotypes can lead to internalized homophobia, which in turn can inspire OCD to manifest around the theme of pedophilia. Folks with POCD may ask:

  • How do I know if I’m a pedophile?

  • What are signs that I’m a pedophile?

  • What if I get arrested under suspicion that I’m a pedophile because of XYZ?

Polyamory, Kink, and other Non-traditional Relationship Styles

Folks with OCD who identify as polyamorous or engage in other non-traditional relationship styles sometimes struggle with the freedom of choice and lack of imposed structure inherent in these relationship styles. They may obsessively ask:

  • How open or closed should my relationship be? 

  • Do I really want to be poly? What if it’s just avoidance of intimacy? 

  • How do I know what labels to use for my partners?

  • What if I’m making the wrong choice? Will polyamory ruin my relationship?

  • For kink-centric relationships: 

    • Am I giving too much power to my partner? 

    • What if I’m too kinky or not kinky enough for my partner?

    •  What if asking to include my kink more in the relationship will ruin it?

Of course the above are all just a sampling of the many ways that OCD can manifest. If you don’t see yourself reflected above but are still struggling with obsessions and compulsions, know that OCD is as unique and diverse as humanity itself. That said, it is my hopes that pointing out these trends can help some readers feel less alone in their struggles. As I always say, OCD is very treatable. If you’ve been struggling, don’t wait any longer to seek help!

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