Gender OCD (GOCD) is a subtype of OCD characterized by doubts and concerns about your true gender. GOCD is not the same as gender dysphoria, and can be treated successfully with exposure and response prevention (ERP) therapy.
When it comes to obsessive-compulsive disorder (OCD), nothing is off-limits. Obsessional themes can range from a fear of getting sick to violence, sexuality, religion and more. So, it’s no surprise that OCD can also instill doubt and uncertainty about gender. This subtype of OCD is often known as gender OCD, or GOCD.
If you have GOCD, you’re likely focused on trying to gain absolute certainty about whether the gender you’ve been identifying with is your true gender—and whether your intrusive thoughts indicate an underlying, unrecognized desire to transition. While questioning your gender can be an important part of understanding yourself, GOCD (like many forms of OCD) isn’t about learning to honor your true self; it’s about an inability to tolerate uncertainty.
People with GOCD aren’t terrified of being transgender, non-binary, or gender non-conforming. They’re terrified of never being fully sure of what their true gender is. This doubt and anxiety fuels a cycle of debilitating symptoms that usually has very little to do with whether or not you’re actually transgender.
Luckily, GOCD—like all subtypes of OCD—is treatable. Through exposure and response prevention (ERP) therapy, you can learn to better manage your GOCD symptoms, and find relief from anxiety and doubt. Read on to learn more about gender OCD, how to get help, and how to distinguish between OCD symptoms and genuine questions about gender.
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What is gender OCD?
Gender OCD (GOCD) is a subtype of OCD characterized by obsessions and compulsions that focus on gender. Like all forms of OCD, people with GOCD experience obsessions— thoughts, feelings, urges, images, and sensations that cause significant anxiety and distress. If you’re dealing with GOCD, your obsessions likely focus on excessive doubts about what your true gender really is.
While some people may experience intrusive thoughts like this from time to time, people with GOCD become obsessed by these concerns, experiencing extreme anxiety. In response, they turn to compulsions to try to gain total certainty about what’s going on. These behaviors may include thought suppression, rumination, and other mental compulsions to try to alleviate negative emotions or try to prevent a bad outcome from happening. Some people may also try to check their gender, by trying on clothes associated with another gender to see how they feel, or engaging in excessive online research to see if they identify with trans communities.
While these behaviors can be important methods of exploration for someone who is truly questioning their gender, they take on a different meaning for people with GOCD. OCD compulsions like checking or rumination exacerbate OCD obsessions, by reinforcing the idea that you need these behaviors to cope with your fears. If you have OCD, you’re unlikely to find the certainty you seek through these behaviors, so your doubts will re-emerge, and the cycle continues.
It’s important to note that while GOCD can seem similar to gender dysphoria, GOCD is its own distinct mental health condition. Read on to learn more about these differences.
Gender OCD vs. gender dysphoria
Gender dysphoria is the distress some people feel when their bodies, presentations, or society’s perceptions of them don’t align with their true gender. It can also describe the discomfort some trans people have when they are treated as the wrong gender. People who experience gender dysphoria often identify as transgender, non-binary, or gender non-conforming. Gender dysphoria has nothing to do with OCD or GOCD. If you’re questioning your gender, it’s important to understand this distinction.
Here are some of the key differences between GOCD and gender dysphoria:
- People with GOCD often have a history of other OCD symptoms. If you’re dealing with GOCD, it’s likely you may have experienced other subtypes or themes of OCD in the past (even if you weren’t aware at the time). An OCD specialist can help you get accurately diagnosed.
- People with GOCD usually don’t have a long history of questioning their gender. While people with gender dysphoria can usually point to times throughout their lives when they questioned their gender, people with GOCD often describe the onslaught of intrusive thoughts as coming on suddenly—sometimes in response to a specific situation. That being said, anyone can experience GOCD, including trans, non-binary, and gender non-conforming people. If you’re unsure about what you’re experiencing, there are OCD specialists in the LGBTQIA+ community who can help you figure out what’s an obsession and what’s a valid question.
- People with GOCD are more focused on attaining 100% certainty about their gender, but don’t necessarily feel distressed living as the gender they’ve been assigned at birth. If you have GOCD, core concerns usually revolve around the fear of living a lie, and the fear of never having certainty about your true identity—not, the emotional pain associated with not being able to live as your true self.
Common symptoms of gender OCD
People with GOCD become preoccupied with fear and doubt over their gender identity. If you’re dealing with GOCD, you can spend hours dwelling on these fears. Common obsessions include:
- What if I’m not who I thought I was?
- What if I don’t know who I am?
- How can I know for sure that I am the gender I was assigned at birth?
- How can I know for sure that I am transgender?
- What if I never figure out my true gender?
In response to these fears, people with GOCD engage in various compulsions in the hope of reducing anxiety and obtaining certainty. Common compulsions include:
- Testing emotional responses to certain thoughts and situations. For example, trying on clothes associated with another gender, to test your emotional response.
- Searching your memory for times you felt sure about your gender, to try to gain total certainty.
- Engaging in excessively online research.
- Ruminating.
- Avoiding specific people, places, and things that might trigger your obsessive thoughts.
- Seeking reassurance from others that the gender you’ve been assigned at birth is your true gender, or that you are actually transgender.
How to treat gender OCD
The most effective form of treatment for gender OCD (GOCD), and all forms of OCD is a specialized form of cognitive behavioral therapy (CBT) called exposure and response prevention (ERP) therapy. ERP was designed to treat OCD, and has been shown to be effective in over 80% of patients. It works by helping you gradually and intentionally face your fears, while learning to resist compulsions—disrupting the OCD cycle.
If you’re struggling with gender OCD, an ERP therapist can help you learn to feel more comfortable with doubts about your true gender. This might involve engaging with topics around gender or transness—while resisting the urge to compulsively check for your emotional responses. Or, it might mean journaling about what it would mean to never gain total certainty about your true gender, and practicing sitting with any feelings of discomfort that arise. ERP therapy helps you learn to stop engaging in compulsions, teaching you that you don’t need these behaviors to manage your intrusive thoughts. In time, the distress you feel from your obsessions will pass more quickly. If it turns out gender or sexuality is a topic you want to explore further, ERP therapy can help you learn to better identify what’s an obsession and what’s a valid question—so you can live your most authentic life without fear or compulsions.
Key takeaways
- Gender OCD (GOCD) is a subtype of OCD characterized by obsessive doubts about gender.
- Unlike people with gender dysphoria, people with GOCD are driven by a desire to gain total certainty about their true gender—not distress about being perceived as the wrong gender.
- GOCD, like all forms of OCD, is best treated through exposure and response prevention (ERP) therapy, which can help you learn to resist compulsions when facing your fears.
