Expert Help for Obsessive-Compulsive Disorder

Behavioral Wellness Clinic
6-D Ledgebrook Drive
Mansfield Center, CT 06250
Office: (860) 830-7838

Monnica Williams, Ph.D.
Clinical Director

Offering expert treatment for all types of OCD, including sexual obsesions. Our OCD treatment program is typically 20 sessions. We offer twice-weekly sessions and intensive programs. Intensive program can be in person or combined with Skype. State of the art medication management is also an option. Low cost options available. [More.]

Sexual Thoughts in OCD

Sexuality Concerns in Obsessive-Compulsive Disorder (OCD)

Many people with obsessive-compulsive disorder (OCD) have sexual obsessions, or unwanted sexual thoughts. This may include sexual orientation fears, which is sometimes referred to as sexual orientation OCD (SO-OCD) or HOCD. Theses are not the same as fantasies or being homophobic.

Sexual thoughts in OCD may include the following:

  • the obsessive fear of being or becoming LGBTQ
  • intrusive, unwanted mental images of upsetting sexual behaviors
  • the fear that one may become a pedophile
  • the fear of becoming sexually aggressive

The Worst Kind of OCD

Although people with OCD may obsess over any number of concerns, one of the most upsetting types of OCD involves worries about causing sexual harm to a child, sometimes called pedophile OCD or POCD. Although this type of OCD typically receives little attention from the media, the Power to Change recently aired the story of a man whose POCD was so severe he contemplated suicide before he was treated by Dr. Monnica Williams. Hear his story online and learn about OCD treatments from Dr. L. Kevin Chapman. Read his story or watch it now.

OCD Therapy Going Nowhere?

Although any medical doctor can take your blood pressure, only a few can do heart surgery. Likewise, any therapist can help someone who is feeling a bit blue, but only a few can effectively treat OCD. OCD treatment is a type of therapy that requires a specialized protocol called Exposure and Ritual Prevention (ERP or EX/RP). Learn about the Top Mistakes Made by OCD Therapists.

Top Seven Myths About OCD

One stereotype is that people with OCD are neat and tidy to a fault. Actually, nothing could be further from the truth. Although many people with OCD wash because they are concerned about dirt and germs, being tidy is actually not a typical symptom of the disorder. Almost two-thirds of people with OCD are also hoarders... Learn more about the Top Myths about OCD.

Take The OCD Self Test

The OCI-R is a short, reliable, scientific test of common obsessive-compulsive symptoms. This measure was developed by OCD experts. Take our OCD Self Test.

Sexual and Homosexual Worries in OCD

by Monnica T. Williams, Ph.D.

OCD Overview

Obsessive-compulsive disorder (OCD) is considered a type of anxiety disorder that involves recurring, unwanted obsessions and repetitive compulsions. Obsessions are intrusive thoughts that cause severe distress, despite the fact that the individual realizes that the obsessions represent exaggerated fears that are not likely to occur. These obsessions are worries that reach beyond anxiety about everyday problems. So upsetting are the obsessions that the individual attempts to counteract them with a specific behavior or neutralizing thought called a compulsion. The individual feels as though their compulsions must be performed in response to the obsessions. Compulsions are implemented strictly to reduce anxiety or prevent a feared outcome.

Sexual OCD Subtype

Obsessions and compulsions can take many different forms, depending on the individual. Several studies have attempted to classify the various symptom profiles into discrete subtypes of OCD, also called symptom dimensions. The research literature generally agrees that there are about four major OCD subtypes: contamination, doubt/harm, symmetry/arranging, and unacceptable/taboo thoughts. The unacceptable/taboo thoughts subtype has also been called "obsessions without covert compulsions" (sometimes called "pure obsessions" or "pure o" for short). Within this category are sexual obsessions, which are unwanted sexual thoughts, often involving children, family members, animals, violence, or even religious figures. These sexual obsessions may involve homosexual activities or fears about sexual orientation. While much research has been conducted on certain OCD subtypes, very little research has been conducted examining sexual obsessions.

Sexually Intrusive Thoughts

Sexually intrusive thoughts are extremely common, and among the general population, over ninety percent of individuals report having experienced these type of thoughts during their lifetime. Studies have found that as many as a quarter of OCD patients have had a history of sexual obsessions. These numbers may be an underestimate of the actual number of people suffering from unwanted sexual obsessions because the stigma associated with sexual thoughts may cause individuals to avoid reporting their obsessions. Sexual obsessions and sexually intrusive thoughts are equally divided among males and females. These thoughts typically start in early adolescence and may progressively worsen, or have a waxing and waning course.

When conceptualizing sexual obsessions, it is important to recognize that people with sexual obsessions find their thoughts immoral and do not wish to act them out. They are different from fantasies, as the obsessions are unpleasant and provoke guilt, rather than being enjoyable. As a result, the thoughts cause distress, which may be connected to unwanted emotions, such as lust, disgust, anger, and frequently guilt. This distress is directly related to the frequency of the sexual obsessions, and may lead to depression, difficulties concentrating, and anxiety.

Treatment for Sexually-Themed OCD

Sexual obsessions in OCD are frequently misdiagnosed, even by licensed psychologists. Thus it is vitally important that people with sexual obsessions in OCD be treated by an experienced and effective OCD therapist.

More Information

Articles about Sexual OCD


Gordon, W.M. Sexual obsessions and OCD. Sexual and Relationship Therapy, 17(4), 343-354, 2002.

Grant, J. E., Pinto, A., Gunnip, M., Mancebo, M. C., Eisen, J. L., & Rasmussen, S. A. Sexual obsessions and clinical correlates in adults with obsessive-compulsive disorder. Comprehensive Psychiatry, 47, 325-329, 2006.

Williams, M. T., Crozier, M., Powers, M. B.: Treatment of Sexual Orientation Obsessions in Obsessive-Compulsive Disorder using Exposure and Ritual Prevention, Clinical Case Studies, 10: 53-66, February 2011.

Williams, M. T., Farris, S.G.: Sexual Orientation Obsessions in Obsessive-Compulsive Disorder: Prevalence and Correlates, Psychiatry Research, 187: 156-159, 2011.

Williams, M. T., Farris, S. G., Turkheimer, E., Pinto, A., Ozanick, K., Franklin, M. E., Simpson, H. B., Liebowitz, M., Foa, E. B.: The Myth of the Pure Obsessional Type in Obsessive-Compulsive Disorder, Depression & Anxiety, 28: 6, 495-500, 2011.