HOCD or Denial? Understanding the Difference
It’s not uncommon to question your sexuality throughout your life.
For many, these questions may come and go, allowing feelings and identity to be explored with calm curiosity.
For others, these questions may feel less like gentle curiosity and more like a persistent cycle of doubt, anxiety, and a pressing need for certainty.
Questions that may arise include:
· “What if I’m in denial about who I really am?”
· “Why can’t I stop thinking about this?”
· “Does the fact I’m questioning mean I’m hiding the truth from myself?”
If these thoughts feel intrusive, repetitive, and tied to urges to check or analyse reactions, it may be part of what is known as sexual orientation OCD, rather than denial itself.
Understanding why these doubts may become persistent, and ways to approach them without being pulled deeper into fear, can be an important step towards moving forward.
A quick, but important note:
You might see the term HOCD (Homosexual OCD) used online.
It’s an outdated label that’s been replaced with the more accurate and inclusive SO-OCD (Sexual Orientation OCD).
I’ll refer to both here briefly and in parts to help bring awareness to the updated languge to people who may still be searching with the older term and to support awareness around the shift in language.
Table of Contents
1 What is sexual orientation OCD (SO-OCD)?
2 Does OCD make you think you’re in denial?
3 Why SO-OCD can feel like denial
4 SO-OCD and arousal: Why does it feel like I want it?
5 How does it feel to live with HOCD?
6 How to know if it’s HOCD or denial
What is sexual orientation OCD (SO-OCD)?
Sexual orientation OCD (previously referred to as HOCD) describes a way obsessive-compulsive disorder may present, focusing on fears and doubts about sexuality.
Intrusive thoughts, images, or urges may appear repeatedly, alongside a strong drive to feel certain about what these thoughts might mean.
People may notice:
· Thoughts such as, “What if I’m actually gay/straight/bi and do not know it?”
· Worries about being in denial about “true” sexuality.
· Checking feelings or physical reactions around others for signs of attraction.
· Seeking reassurance from friends, partners, or online sources.
· Avoidance of situations, shows, or people that may trigger doubts.
· Mentally reviewing past experiences for “proof”.
These patterns may not feel like a genuine, open exploration of identity.
Instead, they may feel distressing and urgent, drawing individuals into a cycle of searching for an answer before relaxation can occur.
Doubts within SO-OCD may feel particularly sticky when targeting identity, an area that can already feel layered and complex.
Attempts to reach certainty about sexuality may lead to further doubts, reinforcing a loop that may feel difficult to break.
Does SO-OCD make you think you’re in denial?
OCD may take the form of “What if I’m in denial?” thoughts, creating a loop of doubt and fear.
SO-OCD/HOCD thoughts examples might sound like:
· “What if I’m actually gay, straight, bi, pan and hiding it?”
· “What if I’m living a lie?”
· “What if the fact I’m questioning means I’m in denial?”
These thoughts can trigger compulsions, such as:
· Mentally reviewing memories or interactions
· Checking reactions around people
· Seeking reassurance online or from others
Why SO-OCD can feel like denial
SO-OCD might feel like denial because a lot of attention may be given to thoughts, feelings, and physical sensations.
It may feel as if these experiences need to be understood or solved straight away.
The mind may link a thought or feeling with the idea that it needs to mean something about who a person is.
For example, “If I have this thought, it must mean something,” or “If I feel anxious, it must mean something is wrong.”
These patterns can build a story in the mind that can feel convincing.
For example:
· A thought may be replayed many times to try to work out what it means.
· A feeling in the body may be closely monitored and linked with worry.
· Anxiety may be taken as a sign that something important is being missed.
Over time, this can lead to a cycle where the fear of “being in denial” becomes the main focus.
Attempts to feel certain may lead to more checking, analysis, doubt and searching for answers.
This is not to say that thoughts or feelings are evidence for or against a particular identity, but rather that the process of trying to find complete certainty can keep the cycle going.
SO-OCD and arousal: Why does it feel like I want it?
Physical sensations may be noticed during intrusive thoughts, which may feel confusing.
Thoughts that may arise include:
“It felt like I wanted it. Does that mean it is true?”
It may be that:
- Focusing on the body can make sensations more noticeable.
- Anxiety can lead to physical responses, including a groinal response.
- Checking and monitoring reactions can make these sensations feel stronger or more significant.
Arousal and physical sensations can happen in many situations and may not clearly indicate what a person wants or does not want.
Placing high importance on trying to work out what these sensations mean can add to confusion and distress over time.
How does it feel to live with HOCD?
Living with SO-OCD may feel draining and isolating. It may involve:
- Spending long periods ruminating on sexuality
- Feeling distant in relationships due to ongoing doubts
- Avoiding situations, people, or media that may trigger thoughts
- Feeling guilt or shame about the thoughts
- Noticing anxiety increases when trying to seek certainty
- Feeling unsure about identity, leading to low confidence or self-esteem
- Finding it hard to focus at work or in daily activities
- Feeling disconnected from values and interests due to worry
These experiences may affect the ability to feel present, enjoy life, and engage in relationships, leading to emotional and physical exhaustion.
How to know if it’s HOCD or denial
People may wonder, “How can I tell if this is SO-OCD or if I am in denial?”
This question can feel urgent, and it can be tempting to search for certainty.
It may help to notice that this search can become part of a cycle that keeps doubts and distress going.
Instead of aiming to find a clear answer, it may be useful to notice what patterns are showing up, such as:
- Thoughts that feel repetitive and hard to let go of.
- A strong urge to analyse thoughts, feelings, or past experiences to feel certain.
- Checking reactions or seeking reassurance.
- Feeling a need to resolve uncertainty before being able to move forward.
Noticing these patterns does not provide certainty, but it may open up space to respond differently.
This is a place where evidence-based treatments, such as Exposure and Response Prevention (ERP) and Inference-Based Cognitive Therapy (ICBT), can help people learn ways to unstick from the cycle, even while uncertainty is present.
What can help if you’re struggling
It can be challenging when thoughts and doubts feel persistent and difficult to manage.
While it may feel necessary to resolve uncertainty before moving forward, there are approaches that may help in stepping out of the cycle of checking and seeking certainty.
If feelings of overwhelm are present, the following approaches may help:
Pause reassurance-seeking: Noticing urges to check, research, or seek reassurance, and choosing not to act on these urges, can help reduce the cycle of doubt over time.
Allow uncertainty: Allowing thoughts and doubts to be present without needing to find an immediate answer can help reduce the urgency to seek certainty.
Take actions that matter to you: Continuing to do things that are important, even when doubts are present, can help life feel more connected to your values rather than to fear.
Explore evidence-based therapies: Treatments such as Exposure and Response Prevention (ERP), Inference-Based Cognitive Therapy (ICBT), and Acceptance and Commitment Therapy (ACT) can support learning to respond differently to intrusive thoughts and uncertainty while engaging in daily life.
Seek specialist support: Working with a therapist who understands OCD can help you learn skills to reduce patterns of checking and avoidance, even while uncertainty remains.
Summary
- SO-OCD (HOCD) may involve intrusive, repetitive doubts about sexuality.
- Attempts to find certainty can increase doubt and distress.
- Checking, analysing, and seeking reassurance can keep the cycle going.
- Focusing on patterns rather than content may support noticing how the cycle is maintained.
- Evidence-based therapies (ERP, ICBT, ACT) can support responding differently to uncertainty.
- Valued activities can still be part of life, even when uncertainty is present.
You don’t have to navigate this alone, and you can move forward even if uncertainty is present.
FAQ
Q: Can HOCD cause false attraction?
A: Intrusive thoughts and physical sensations may occur during HOCD/SO-OCD, and these can feel confusing.
The urge to analyse or interpret these sensations as attraction can add to the cycle of doubt and distress.
Q: Does OCD make you think you’re in denial?
A: OCD can lead to fears about “being in denial” and may involve checking, analysing, and seeking certainty, which can increase distress and keep the cycle going.
Q: What is the difference between SO-OCD and questioning your sexuality?
A: Questioning sexuality and SO-OCD can feel different in how they show up. SO-OCD often involves repetitive doubts, a sense of urgency, and a need to find certainty, which can feel distressing.
Focusing on these patterns, rather than trying to resolve the doubts, may support noticing how the cycle continues.
Q: HOCD feels like I want it. Does that mean it’s true?
A: Physical sensations and arousal can happen during intrusive thoughts, and monitoring reactions closely can increase awareness of these sensations.
Trying to work out what these sensations mean can add to the cycle of uncertainty.
Q: Why is HOCD so confusing?
SO-OCD (HOCD) can feel confusing because the thoughts often target identity, an area that can feel important and personal.
Attempts to find certainty about thoughts and feelings may increase doubt, making it harder to step back from the cycle.
Q: How do I know if it’s SO-OCD or not?
Wanting certainty about whether doubts are SO-OCD can become part of the cycle.
Noticing patterns like repetitive doubts, checking, and urges to find certainty may help in seeing how the cycle continues.
Treatments such as ERP, ICBT, and ACT can support learning to step back from the cycle, even while uncertainty is present.
Ready to take the next step?
If you’re feeling stuck in doubt or fear, you don’t have to navigate this alone.
With the right support, it’s possible to live a life led by your values, even when uncertainty is present.
Download your Free Anxiety & OCD audio release scroll below to Book a free 15-minute call to explore how I can help.
