Sexual Orientation OCD SO-OCD

What is Sexual Orientation OCD (SO-OCD)?

Please note:  The information on this page should not be construed as medical advice, nor should it be used to diagnose or treat any condition. The content on this page is written by recovered OCD sufferers, not by clinicians. Read More

A comprehensive guide to Sexual Orientation OCD (SO-OCD)

Sexual Orientation OCD (SO-OCD) is a type of OCD that involves obsessions, compulsions and fears concerning one’s sexual orientation and sexual preferences.

According to fairly recent evidence, almost one in three (32%) OCD patients have sexual obsessions; as SO-OCD is invariably one of the primary forms of sexual OCD, it is therefore a fairly common subcategory of the disorder.

This guide to Sexual Orientation OCD (SO-OCD) is meant to provide useful information about the symptoms, causes, treatment options and other relevant information on the topic.

A short history of the term “Sexual Orientation OCD (SO-OCD)”

Sexual Orientation OCD (SO-OCD), according to Google Scholar search query data, is a term that has been in use in academia for less than 10 years (with the search query “Sexual Orientation OCD” yielding only 1 result in papers from 2012 and earlier, and 57 results between 2013 and 2022).

According to a paper from the journal “Behavior Therapy”, sexual orientation-related obsessions and compulsions were initially assumed to only apply to heterosexual persons having fears that specifically revolve around potentially being or “turning” gay or bisexual; this is due to widespread beliefs of heteronormativity (that heterosexuality is the “standard” sexual orientation) before the LGBTQ movement started gaining significant momentum in the early-to-mid 2010s.

Before the term SO-OCD, the term H-OCD (homosexual OCD) was used in internet self-help communities and forums in the early days of the internet/world-wide web. The term SO-OCD essentially replaced H-OCD, since it is simply a more inclusive and all-encompassing term (the explanatory scope of H-OCD is also too narrow).

How many people have Sexual Orientation OCD (SO-OCD)?

The current data shows that 2-3% of the general population has OCD; however, an estimate of the amount of people who have SO-OCD is difficult to establish.

As nearly 1 in 3 people have sexual obsessions, it can therefore be assumed that roughly ~0.66%-1% of people have some sort of OCD that revolves around sex or sexuality; nonetheless, SO-OCD is specific and can only apply to people who have a combination of obsessions and compulsions particularly to do with sexual preference and/or orientation.

Interestingly, sexual compulsions are more common in men, which makes it quite likely that the majority of people who suffer from SO-OCD are male.

Examples of SO-OCD

  • Thoughts of potentially being sexually attracted to members of the same sex, despite being of a heterosexual orientation
  • Thoughts of potentially being attracted to both men and women (bisexuality), despite being of a heterosexual orientation
  • Wanting to seek reassurance about one’s sexual orientation from others
  • Constant analyzing of how others view your sexual orientation
  • Reviewing one’s memories for any sign that might suggest one’s sexual orientation has changed over time
  • Avoiding erotica or pornography involving the same sex due to fears of having one’s sexual orientation changed
  • Compulsively checking one’s house or belongings (e.g. clothing) for signs that could identify them as already being of a different sexual orientation
  • Avoiding people of the same sex, or anything that could be associated with the same sex, out of fear of being “infected” with same-sex attraction

What causes Sexual Orientation OCD (SO-OCD)?

According to Storch and Lewin’s “Clinical Handbook of Obsessive-Compulsive and Related Disorders”, the cognitive-behavioral model of OCD states that sexual obsessions are caused by a person adding too much personal significance to their unwanted/intrusive sexual thoughts, impulses and images, which subsequently results in them feeling doubt and distress.

In more general terms, nature (genetics) and nurture (physical/social environment) both seem to play a role in regards to how obsessive-compulsive behaviors develop, with the former accounting for 36% and the latter accounting for about 64% of behavioral factors.

How can SO-OCD be treated?

With SO-OCD, the most effective treatment is probably what’s known as ERP (exposure and response prevention), which has an average 50-60% efficacy rate for reducing OCD symptoms.

In one 2011 study with a 51-year-old male patient named Simon with sexual orientation-related OCD, the patient had ERP sessions for 12 weeks; at his baseline evaluation, his OCD symptoms were rated a “24” on the YBOC (Yale-Brown Obsessive Compulsive) scale, which is on the high side of “moderate symptoms” (which is “14-25” on the scale, with “26-34” being “moderate-severe symptoms”). His score reduced to a “3” after his ERP sessions, which means his OCD was no longer considered clinically significant.

Another option is medication, such as SSRI-category antidepressants. According to the current data, 40-70% of patients respond well to SSRI trials and usually have a remission rate of 10-40% in terms of their symptoms.

What is the Sexual Orientation Obsessions and Reactions Test (SORT)?

The SORT (Sexual Orientation Obsessions and Reactions Test) is a clinical scale specifically made by mental health professionals to assess the severity of SO-OCD symptoms, and to also have a scale that can be used to differentiate SO-OCD from unrelated issues or concerns to do with sexual orientation, such as a sexual identity crisis.

The scale has twelve items, which are statements that the patients has to rate on a 5-point scale from 0 (“never”) to 4 (“always”); the questions revolve around sexual orientation, fantasies, arousal, and worries about potentially being LGBTQ, or having a different sexual orientation.

You can look at (or take) the test here.

What is the difference between SO-OCD and a sexual identity crisis?

A sexual identity crisis is essentially a period in someone’s life when they’re unsure of their sexual orientation; this can be a time of confusion and stress, but it is a fairly common occurrence (especially in adolescence or early adulthood) and it is not usually considered to be a mental disorder.

In contrast, SO-OCD is a mental disorder that is characterized by intrusive thoughts and compulsions specifically related to one’s sexual orientation.

Talk to other people about Sexual Orientation OCD (SO-OCD)

Make sure to check out our community forum where we even have an SO-OCD subcategory; here you can speak to other sufferers of OCD and talk to them about personal experiences, treatments and so on!

Start the discussion at

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