HOCD is the shortened name of a rare form of obsessive compulsive disorder, termed “Homosexual Obsessive Compulsive Disorder,” or sometimes called “Gay OCD” or Sexual Orientation OCD. Obsessive Compulsive Disorder is a behavioral disorder wherein people commonly have intrusive thoughts or obsessions, which they are unable to get out of their mind, unless they engage in a specific behavior or pattern of behaviors, to make the thought go away (and the anxiety with it).
For instance, a person might have an intrusive, uncomfortable, anxiety-producing fear that they might have left the stove on that morning as they left the house. So, in order to make the fear go away, they then drive home, check the stove, and reset the stove switch to the off position, twenty times, to ensure it is off and their house isn’t going to burn down. OCD used to be classed as an anxiety disorder, but has recently been clustered in the DSM-5 with other disorders such as body dysmorphic disorder, hoarding, trichotillomania, etc., with the recognition that these disorders involve anxiety-related components, but are more similar to other compulsive, repetitive behavior disorders.
There’s no clear answer as to where these specific obsessive thoughts come from, or why different people have different obsessive thoughts or fears (ranging from fears of contamination or germs, to obsessive thoughts about one’s safety). As with many things, these obsessive thoughts likely emerge from an interaction of the person with their environment, filtered through the biology of their brain and their genetic history. OCD is currently diagnosed with an indicator as to whether the person has insight, and recognizes that these thoughts are unlikely to be true, and has insight into their improbability, or not.
HOCD is one form of OCD, where the obsessive thought is, in essence, “Maybe I’m actually gay.” This thought, perhaps in reference to accidentally looking at another male in the restroom, triggers anxiety and fear from a person. This fear may seem somewhat far-fetched today, in our society, which has become more accepting of homosexuality, and many people might respond and say “So what if you are, it’s not a big deal anymore!”
But, for the person experiencing HOCD, the thought, the obsession, is really just a vehicle for the anxiety and the repetitive behavior. The thought isn’t really a rational fear in many cases, and some people can recognize that it’s unlikely. But, that doesn’t stop the overwhelming anxiety which accompanies the thought, and leads then to the compulsive behavior. For many with HOCD, the compulsive behavior, to relieve and banish the obsessive thought “I might be gay,” is to watch gay porn, or even find someone to have sex with. In either case, the person suffering from HOCD is using this behavior to check, to see, “Am I gay?” by monitoring their response to either the porn or the encounter. So, in their head, they’re checking and seeing, “I’m not getting aroused, I’m not finding this sexy, so I’m not actually gay,” which allows the fear and obsession to be put away, at least till next time. Here is a pretty good self-test for HOCD, that gives a nice idea of the types of fears, obsessions and behaviors that characterize HOCD. http://ocdla.com/gay-ocd-hocd-test. There have been rare cases of people who are gay, having comparable intrusive fears that they might actually be straight.
Like many sensationalized mental health disorders, HOCD can often be misunderstood, and misapplied by people who are not clinicians. Currently, HOCD has been mistakenly applied to a hypothetical effect of excessive pornography consumption, whereby someone (ostensibly a heterosexual) begins to respond to homosexual porn as a result of HOCD.
On one forum an individual stated “Those with HOCD—long term porn usage has conditioned your brain to associate the penis as a pleasurable object. You don't find men sexually attractive in real life but you think of a penis and your brain only knows to associate it with PLEASURE.”
On the No-fap site, one young man tells a story about how he watched lots of pornography, and then once found himself “noticing” a man’s butt. This led to him increasingly fantasizing about homosexual experiences, becoming aroused watching homosexual pornography, and then began to worry that he might be gay. “I began doing research every day on HOCD and the possibility of a porn addiction being the cause. I would start analyzing childhood memories for signs of being gay, or even paying attention to the way I speak or look to see if I resemble a gay person. There came a point where I started feeling less anxiety and wasn't as depressed, and THAT worried me! I kept thinking, "what if this means I don't have HOCD and I am actually in gay or bi denial?!"
And on yet another forum, a man posted this: My HOCD has just gotten worse... I've been masturbating for like 3 years & I've never thought I would be addicted. I started off with girls in their underwear and all that. As the years have progressed I've been masturbating daily. Straight porn doesnt even catch my attention anymore. So I started masturbating to guys masturbating. It feels good and I can orgasm to that kind of porn… After I am done I have no feelings towards guys. I just find their penis attractive. I think that I like that kind of porn because nothing else can make me orgasm...Kissing a guy would make me BARF…I need to know if this means I am gay, which I would personally hate to be. Or is it the porn.???
Clearly these young men are concerned and anxious. But is this HOCD? The strongest reason why these are not forms of HOCD is that the sexual behavior comes first. Remember, in OCD, obsessions trigger a behavior to relieve the anxiety associated with the obsession. The obsession, the thought, starts the chain of anxiety. In the stories associated with HOCD online, attributing it to porn, the sexual behavior (watching porn and masturbating) precedes the anxious fear that the man might be gay, because they are becoming aroused by this experience or stimuli. Secondly, the sexual behavior of HOCD is not, in almost all cases, a pleasurable one. In fact, the lack of pleasure often provides the actual relief, assuring the individual that they are not in fact homosexual.
If HOCD isn't an accurate or useful way to understand this experience, what’s going on with these men? Well, for one thing, people who watch more pornography become more accepting of sexual diversity, including homosexuality or kinky behaviors. Watching more porn involves being exposed to more forms of sexuality, and learning that appreciating a man’s body doesn’t make the world end, or that meteors don’t fall from the sky and set you on fire if you’re aroused by an experience you were taught to be afraid of or reject.
People who watch more porn tend to be people with higher libidos who tend to be high in sensation-seeking tendencies. So, the effects of destigmatizing sexual diversity or homosexuality from watching porn, in a person who tends towards sensation-seeking, might lead to a relaxing of that person’s internal barriers to sexual arousal or fantasy, if they, like many men in our society, were taught to internally shame or fear homosexual arousal.
Finally—these men sound very similar to the “mostly straight” men described in recent research by Hector Carillo and Amanda Hoffman. In that research, 100 men were interviewed who identify as straight, but have sex with men. These men described things such as “From time to time I might get the urge to have sex with a guy, but I’m not attracted to them,” and that these men felt that male bodies weren’t sexually arousing, but penises were. They often describe the typues of behaviors they will do with men, such as oral sex, but draw lines about the behaviors they refrain from (such as kissing) because these behaviors would conflict wit their heterosexual identity. It’s noteworthy that this group of non-heterosexuals may actually be the largest group of non-straight people, where there are more people who identify as straight, but sometimes experience same sex arousal or sex, than there are all other non-heterosexuals combined. So, it is extremely possible that these men uncomfortable at experiencing arousal and interest in homosexual porn, and blaming it on HOCD, are only “mostly” straight (to mildly paraphrase Miracle Max from Princess Bride, who famously says that Wesley is only “mostly dead.")
It’s always risky to trust medical or clinical information from the Internet, or from Internet forums, because it can so often be wrong. In this case, telling young men that they have a scary-sounding disorder may actually be doing harm, and increasing their anxiety. It also furthers the stigma associated with same-sex desires or arousal, and inhibits the degree to which these men can learn to understand and accept their experiences and arousals, seeing that their sexuality is something which is broad, evolving and wonderful—not scary or pathological. Finally, I think it very likely that people who actually experience HOCD could be confused or harmed by these inaccurately applied concepts, if these individuals fall into these groups, rather than seeking treatment from a qualified therapist. In these online groups, the prescription is normally to “stop watching porn or masturbating for 90 days.” Unfortunately, for a person with HOCD, treatment is much more complex, and porn is merely a symptom.
If you are concerned you might have HOCD, please check with a licensed mental health clinician. If you are turned on by gay porn, but identify as heterosexual, feel free to keep that identity, but consider that you might actually be one of the many people whose sexuality is not quite as black and white as we might like to think.