If you are an HOCD sufferer, you’ve almost certainly read an article called “I’m Gay and You’re Not: Understanding Homosexuality Fears” by Mark-Ameen Johnson, a gay man with a history of OCD. The purpose of the present article is to explain why that article is both misguided and potentially harmful to HOCD sufferers, and to offer more accurate information about HOCD.

But first, one quick disclaimer and one trigger warning:

Disclaimer: I am going to argue that Mark’s old article is very wrong about HOCD. This is not an ad hominem attack. Mark spent time and energy trying to help people suffering from HOCD, and that is laudable. In fact, Mark and I have been in touch since I originally posted this article, and he’s told me that he has learned more since writing his article, and now agrees with the critiques below. Mark has told me that he wrote his article back in 2005, in an effort to address the questions that people with HOCD were asking him. He’s asked me to publicize that if he were writing his article now, it would be quite different.

Trigger warning: People with HOCD often read articles and forum posts for reassurance. Their logic is basically that if people with HOCD describe similar experiences to them, then it must be the case that they also have HOCD, and aren’t really gay (a false dichotomy); so the posts and articles are not only validating, but also reassuring. This article will not be reassuring. It will not make you feel better or more certain of your sexual orientation. It may therefore cause a sharp increase in your anxiety.

Mark’s premise

Although he didn’t use these terms, Mark’s basic argument was that if sexual feelings are ego-dystonic – meaning they don’t feel like you – they are not real and do not define your sexual orientation.

He opened with the assertion that “If you say you are heterosexual, then you are. Period.” He then proceeded to explain that based on his experience, anything OCD says is automatically false. Specifically, he said, “HOCD obsessing over being gay = straight in reality.”

He thus immediately reassured readers that he agreed they weren’t gay, based on the fact that they had HOCD.

The problem with Mark’s premise

There are a few problems with Mark’s premise:

It’s not true: It is not at all true that having HOCD indicates you’re not gay. To be clear, it also doesn’t indicate you are gay! Having HOCD doesn’t tell you anything about your sexual orientation whatsoever. All it tells you is that you have OCD about your sexual orientation, which you already knew.

It’s not helpful: Reassurances like this are useless. If an HOCD sufferer could just say to herself, “If I think it’s true it must not be true!” and then continue about her day, she wouldn’t have HOCD. Reassurances like this leave sufferers feeling better for a minute or a day, only to fall victim to another spike.

It’s harmful: Mark’s article is full of (false) reassurance. Reassurance is compulsion and compulsion maintains OCD.

Delving further into Mark’s arguments

Mark gave the following examples of the distinct thought processes of a straight HOCD sufferer and a gay person:

HOCD sufferer: “I know that I am gay, but I have only ever gotten hard with girls. This must be because I am in the closet, and I know that I’ll suddenly get hard with guys once I come out. But the thought of being with another guy makes me sick. Damn, gay stuff is so disgusting! I’d never want some naked guy to touch me that way. But my mind tells me that this is what I want, and that I’ll be O.K. with it once I come out because I am gay. But I’m not gay! But my mind tells me I am. Dammit, why won’t my mind shut up? I do all this checking by looking at gay porn, and I still don’t know what I am. But I just want to look at hot women instead. I have never been attracted to guys, but I know I am a gay guy. This anxiety is killing me. I can’t even hear the word gay without becoming anxious.”

Gay person: “I know that I am gay, and I have only ever gotten hard with guys. I am in the closet because I am afraid people will reject me, yet I have always wanted with everything in me to fall in love with another man who loves me back. That would be so beautiful. I was taught that gay stuff was disgusting, but when I think of being held by a man I get butterflies in my stomach. When I see a guy I like, it just feels right. The only anxiety I feel is over what others think of gays and how I think I’ll be treated by straight people in power if they find out about me. I don’t feel any anxiety when I think about how lucky gay guys who are out of the closet must be, and I wish I could be like them.”

He was basically saying you could tell the difference between HOCD sufferers and gay people based on three things:

1) a clear pattern of sexual arousal

2) a clear sense of what is desirable and what is disgusting

3) a clear distinction between anxiety based on other people’s homophobic beliefs and anxiety based on one’s own internalized homophobic beliefs

If you have HOCD you wish that these distinctions were clear, but you know they’re not. Here’s why:

1) Sexual arousal patterns aren’t always clear. Sometimes you get aroused by things that don’t usually arouse you. Sometimes you prevent yourself from getting aroused. Sometimes you feel something in your genitals and don’t know if it’s arousal at all. Sometimes you can’t tell the difference between sexual arousal and anxious arousal. Sometimes anxious arousal blocks sexual arousal, both when you’d like to be aroused but aren’t, and when you don’t want to be aroused and anxiety prevents it from happening.

2) When you have OCD you can’t always tell what’s desirable and what’s disgusting. You may think about something that you’re afraid will arouse you, and then immediately undo it by thinking about how disgusting it is. You may have obsessive thoughts that tell you that you like things you actually do find disgusting. You may reassure yourself that you’re straight because specific sexual acts seem disgusting. You may be so anxious about all of these thoughts and feelings, that you don’t know which way is up. You may find certain things aversive because they threaten your sense of self, even if they are also sexually arousing, or would be sexually arousing if they weren’t so threatening.

3) Internalized homophobia is very real. Lots of people with HOCD say they have no problem with gay people or being gay themselves, as a way of reassuring themselves that if they were really gay they would readily accept it. Unfortunately, living in a homophobic society (and our society is still homophobic even though it’s relatively less homophobic than other places or any other time in history) still leaves all of us with some negative feelings about homosexuality. Therefore, the distinction between worrying about what others will think and worrying about what you yourself think is not always so clear.

The article claimed that “On a primal level … gay people always know that they are gay no matter what tricks society employs. Straight people always know that they are straight no matter what tricks HOCD employs.”

If you’re an HOCD sufferer I don’t have to tell you what the problem with this is: “How do you know if you know? What does it mean to know? I think I know but what if it’s denial? I worry it’s denial but what if it’s OCD?”

Sitting in front of your computer and trying to figure out if you’re gay is the very process that’s keeping you stuck. But that doesn’t mean there’s no hope. Cognitive-Behavioral Therapy for OCD (AKA Exposure with Response Prevention AKA ERP AKA ExRP) can help you to get unstuck and gain greater clarity about your sexual orientation. An article that reassures you you’re straight will not help you.