Our sexuality determines who we’re attracted to—or not attracted to—and can dramatically influence our relationships, experiences, and even sense of self. Most people’s sexual orientation emerges in early adolescence, while others may not figure out their sexuality or gender identity until they are adults. Further, some people find putting labels on their feelings difficult, or discover that their feelings change over time.
But here’s the thing: Obsessive-Compulsive Disorder (OCD) doesn’t care if you are actually secure in your sexual orientation. It only intends to breed doubt and distress. A subtype of the condition known as Sexual Orientation OCD (SO-OCD) barrages people with unwanted, intrusive thoughts and doubts about their sexuality—latching onto even the possibility of uncertainty—and leads them to engage in compulsive behaviors to feel better, if only temporarily.
Believe it or not, some of these compulsions actually involve using pornography in an attempt to feel certain about one’s sexual orientation. Let’s learn more about why watching porn might be compulsive, how you can learn if your own behaviors are SO-OCD compulsions, and what you can do to get your life back on track if you’re struggling with the condition.
What is obsessive-compulsive disorder?
Affecting an estimated 1-2% of the population worldwide, OCD is a serious and often misunderstood condition, characterized by intrusive, distressing thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) intended to neutralize the resulting distress.
You can think of obsessions and compulsions as the active components in a vicious cycle that, without proper treatment, people with OCD struggle to escape. Here’s how it works:
- Obsession: The cycle is triggered by an intrusive thought, image, situation, or feeling that causes distress. Often irrational and unwanted, these obsessions are ego-dystonic, which means they go against the person’s actual identity or values.
- Compulsion: To reduce their distress or anxiety, people with OCD engage in compulsive behaviors or mental rituals. Common examples include avoidance, checking, or seeking reassurance.
- Relief: Compulsive behaviors provide temporary relief, but they actually reinforce the belief that these actions are necessary to avert harm or alleviate anxiety. As a result, the cycle continues, further strengthening the connection between triggers, obsessions, and compulsions.
Many people erroneously use “OCD” as a shorthand to describe liking or needing to do something a certain way: “I’m a little OCD about organizing my closet.” However, an actual diagnosis of OCD requires obsessions and compulsions to be time-consuming (take more than one hour per day), cause significant distress, or interfere with daily functioning.
Now that we know what OCD looks like and how therapists diagnose it, we can learn more about the specific subtype of SO-OCD, and how watching pornography can sometimes become a compulsion that contributes to the OCD cycle.
Sexual orientation OCD (SO-OCD) explained
Sexual orientation OCD (SO-OCD) refers to a type of OCD characterized by obsessions related to doubts about one’s own sexual identity and compulsions intended to relieve anxiety caused by this uncertainty. It can be experienced by anyone, regardless of their gender or sexuality.
Common SO-OCD obsessions
As with all OCD subtypes, SO-OCD obsessions show up differently from person to person, but some more common ones may include:
- Fears that you are in denial about your sexuality
- Concerns that you will “turn” gay, straight, or bisexual and that your relationship will be ruined as a result
- Obsessions about whether you’ve behaved or interacted with others in a way that you associate with a different sexual orientation
- Worries about losing your identity and “true self” if your sexual orientation is different than the one you identify with
Common SO-OCD compulsions
Common SO-OCD compulsions also vary between individuals but may include:
- Repeating certain phrases to alleviate anxiety or prevent unwanted thoughts related to sexual orientation
- Devoting time to research, reading, or online searching about sexual orientation to find answers or evidence to support or refute your doubts
- Repeatedly reviewing past thoughts, feelings, and experiences to analyze your sexual orientation, seeking certainty or confirmation
- Avoiding situations, people, or media that may trigger intrusive doubts about your sexual orientation to manage anxiety or uncertainty
- Continuously analyzing your thoughts, feelings, and attractions in an attempt to make sense of your sexual orientation
- Taking part in activities to test or prove your sexual orientation, hoping for a definitive answer—activities like watching porn
In the next section, we’ll examine why watching porn can become a safety-seeking compulsion for many people with SO-OCD.
Why might people with SO-OCD watch porn as a compulsion?
Porn is more accessible than ever before. This is chiefly because it’s effectively free and consumable via the same devices we use to do pretty much everything else. Whether watching porn is healthy is a hotly debated topic. But it’s assuredly not healthy when it becomes compulsive, as a means of seeking relief from obsessions in SO-OCD.
“In my experience, people with SO-OCD watch porn as a compulsion in one of two ways,” says therapist Aaron Hensley, MSW, LCSW. “In the first instance, they’re watching porn that aligns with their sexual orientation. So, a gay man who is experiencing doubts about whether they are indeed gay may watch gay porn and use their arousal as evidence of their true orientation. However, that gay man might also use heterosexual pornography to prove they’re not attracted to someone of the opposite gender by hoping they aren’t aroused.
“In either case, this is a checking compulsion,” Hensley explains. “This person is checking that they are aroused by images that align with their orientation and aren’t attracted to images that don’t. Their OCD tells them that if they watch this porn, they’ll have some certainty about their sexual orientation. However, in my experience working with members, watching porn tends to make the situation quite a bit worse in the long run.”
One of the reasons why porn watching can exacerbate things, says Hensley, is a phenomenon called the groinal response. This sudden physical arousal can happen to anyone due to intrusive thoughts and isn’t limited to people with SO-OCD. Merely experiencing a sexual thought can trigger a physiological reaction in the body. The brain sometimes signals the body to experience arousal when humans sense or imagine something of a sexual nature, often without necessarily corresponding with a person’s actual identity, attraction, or preferences.
In other words, even physical signs associated with arousal aren’t “proof” of attraction or identity: the gay man referenced above could have a groinal response while watching heterosexual porn, and their OCD will latch onto their response and use that as “proof” that their sexuality is in doubt. In turn, this can lead to more assessment, checking, doubt, and distress.
When people with SO-OCD encounter a groinal response to these thoughts, they often become further disturbed by their obsessions. Their minds can get trapped in a vicious cycle, questioning how they could have such thoughts, contemplating the possibility of acting on them, and worrying about doubts that they are not their true selves.
“It’s crucial to understand that the groinal response to such thoughts is purely a biological reaction and can occur in anyone, regardless of their true values or intentions,” says Hensley. “But when people don’t have a lot of insight into their condition, this can cause them to spiral.”
It’s crucial to understand that the groinal response to such thoughts is purely a biological reaction and can occur in anyone, regardless of their true values or intentions.
Aaron Hensley, MSW, LCSW
Hensley adds that a lack of a groinal response can also make things worse. If a gay male were to watch gay porn and not feel aroused, then that could also sow seeds of doubt as well. He notes that this can not only lead to an increase in the duration of their porn-watching, but also provoke an uptick in content’s intensity: “I’ve worked with people who found their way to really dark things that they found deeply unpleasant, all in an attempt to reassure themselves that they wouldn’t be aroused, but it simply never works,” says Hensley. “OCD is never satisfied with whatever we give it.”
In addition to taking up hours of their day, compulsive porn watching can begin to impact various aspects of a SO-OCD sufferer’s life. Henlsey points to the effects of compulsive porn watching on people’s relationships, social life, and even how they function at work.
“I’ve had people who’ve reported leaving work early to go home and watch pornography because they became overwhelmed with racing thoughts and fears. I’ve had people who have told me they’ve had to go to the bathroom to look at pornography on their phone because they got triggered by something at work, and they feel as if they have to use porn to check their response immediately.”
Hensley adds that even though these behaviors feel urgent and necessary, it is possible for people to manage them and regain control of their lives—even if it means tolerating uncertainty about something as important as their sexuality. “Managing your compulsive porn watching, along with any other SO-OCD symptoms, can be a life changer,” says Hensley. “In most cases, that’s exactly what ERP does.”
Exposure and response prevention therapy (ERP) for SO-OCD
Exposure and Response Prevention (ERP) is a widely recognized and effective treatment approach for Obsessive-Compulsive Disorder (OCD). Successful for approximately two in three people with OCD, ERP involves systematically exposing people to situations, thoughts, or images that trigger their obsessions while guiding them in resisting their typical compulsive responses. ERP aims to break the cycle and allow people to tolerate uncertainty and doubt.
ERP for sexual orientation OCD involves exposing people to situations that trigger their obsessions regarding their sexual orientation. It effectively reduces compulsions related to sexual orientation OCD because it helps people learn that their obsessions are not indicative of their true sexual orientation, and that they are capable of living with confidence in their sexuality, despite not having 100% certainty about it.
“How we treat SO-OCD with ERP differs depending on the member and their triggers,” says Hensley. “Let’s say we’re using the example of a homosexual woman experiencing obsessions about being attracted to men. We might start by looking at pictures of men they’re worried they could be attracted to. We’d then learn to resist the compulsion to check for groinal responses or other bodily sensations. We will also work on resisting mental compulsions like repeating a phrase that affirms their sexuality. While on the surface that may seem like something healthy to do, in OCD it becomes a compulsion. From there, we would gradually work to do more difficult, anxiety-provoking things.”
You can access expert help today
If you think you might have SO-OCD and are interested in learning how it’s treated with ERP, I strongly encourage you to learn more abou NOCD’s evidence-based approach to treating OCD and related conditions. You don’t have to feel this way forever, and effective help is closer than you may think.
All of our therapists specialize in OCD and receive ERP-specific training. You can also get 24/7 access to personalized self-management tools built by people who have been through OCD and successfully recovered.