Sexual OCD

North Star Psychology
2 days ago
5 min read

Sexual OCD is one of the most disturbing and misunderstood forms of obsessive compulsive disorder. It doesn’t come from desire, it comes from fear. People with this subtype experience intrusive, graphic, and unwanted sexual thoughts that feel completely out of line with who they are. These thoughts are not fantasies, they are mental intrusions that provoke anxiety, disgust, guilt, and shame.

The person doesn’t want the thoughts. In fact, they feel horrified by them. But the more they try to suppress or analyze what the thoughts mean, the more powerful the OCD becomes. It’s a vicious cycle of mental checking, avoidance, and self-doubt.

Sexual OCD can take many forms: some people obsess over their sexual orientation, others are terrified by mental images involving children, family members, strangers, or even animals. These thoughts feel like threats to identity, morality, and safety, and they can destroy a person’s ability to function in everyday life.

Here’s a breakdown of the most common themes and what actually helps.

Sexual Orientation OCD (SO-OCD)

Sexual orientation OCD is centered around fear. The person might be straight, but suddenly get an intrusive thought like What if I’m gay? Or they might be gay and get the thought What if I’m straight now? These are not moments of curiosity; they are obsessions, followed by compulsions.

Compulsions for this might include:

Mentally reviewing past relationships
Looking at photos of attractive people to “test” arousal
Avoiding certain media, clothes, or activities
Asking others for reassurance about how they come across
Repeating phrases to “prove” their identity

The person may feel like their entire sense of self is unraveling.

POCD: Fear of attraction to children

One of the most distressing forms of sexual OCD involves intrusive thoughts or mental images related to children. This is commonly referred to as POCD. The person experiences an unwanted thought such as What if I’m attracted to children? or What if I acted inappropriately and didn’t realize it?

To be clear, these are not fantasies or desires. They are mental attacks that feel deeply violating to the person experiencing them. OCD targets whatever you care about most, and for many people, protecting children is a core moral value, which makes this obsession especially devastating.

Common compulsions for this include:

Avoiding children, playgrounds, or family events
Mentally checking physical sensations when around minors
Replaying past moments to scan for anything inappropriate
Confessing thoughts to partners or pastors
Looking up news stories to compare themselves to known offenders

This OCD subtype is often hidden due to shame and fear of being rejected by people. But it is more common than people think, and it is highly treatable with the right approach.

Incest OCD: Fear of being attracted to family members

Similar to POCD, incest OCD centers on unwanted sexual thoughts involving close relatives. These thoughts are not driven by desire, but are instead intrusive mental images or questions like:

What if I’m attracted to my sibling?
Why did I feel a physical sensation when I hugged them?
What if something inappropriate happened in the past and I blocked it out?

The thoughts trigger intense anxiety, guilt, and revulsion. People with this form of OCD often start avoiding hugs, physical contact, or even eye contact with their family. They may confess repeatedly to loved ones or mentally replay memories to search for reassurance.

Bestiality OCD: Fear of attraction to animals

This version of OCD involves intrusive thoughts or mental images involving animals. The person might see a dog and immediately think What if I’m aroused right now? or What kind of person thinks something like that?

They might then:

Avoid animals entirely
Analyze physical sensations around pets
Mentally punish themselves for the thought
Seek reassurance from religious figures or therapists

Again, the theme is fear, not fantasy. These thoughts feel horrifying, not exciting. But the OCD doesn’t care: it latches on to anything taboo.

Sexual Intrusive Thought OCD: The brain as a graphic slideshow

Some people with sexual OCD don’t fixate on a specific category. Instead, they experience intrusive, graphic mental images involving anyone and everyone: coworkers, teachers, friends, religious figures, even strangers walking down the street.

This might include:

A disturbing mental image that pops up mid-conversation
Graphic thoughts about someone they have no attraction to
Thoughts that intrude during prayer or family events
Mental scenes that repeat again and again, even though they’re repulsive

People often ask themselves, Why did my brain go there? or Does this mean something about me? The obsession isn’t the thought, it’s the need to be sure it didn’t mean anything.

Hyper Awareness of Genital Sensations

This subtype involves constant scanning of the body for signs of arousal. The person may feel a twinge, warmth, or tingling sensation and immediately panic: Was that arousal? Does that prove something is wrong with me?

It can show up around:

Children
Family members
Same-sex or opposite-sex friends
Animals
Clergy, therapists, or authority figures

These sensations are not evidence of desire; the body is reacting to anxiety, attention, and fear. But OCD insists otherwise, and the loop continues.

Fear of Sexually Offending OCD

People with this form of OCD fear that they might accidentally touch someone inappropriately, say something offensive, or engage in behavior that would classify as sexual misconduct.

This might include:

Replaying physical interactions to check if they brushed against someone
Avoiding crowded spaces to prevent accidental contact
Mentally checking whether a look or gesture could be misinterpreted
Asking people to confirm that nothing inappropriate happened

The fear is not rooted in intent, it’s rooted in self-doubt and a desire to be morally clean, or to avoid being labeled or accused.

What Helps Sexual OCD

Sexual OCD can feel like psychological torture. The thoughts are so distressing that many people don’t even tell their therapist, but keeping the fear hidden only feeds the cycle. These thoughts are not dangerous, acting on them is not inevitable; they are symptoms of a treatable condition.

Here’s what helps:

Exposure and Response Prevention (ERP) - ERP is the gold standard treatment for all forms of OCD. It involves gradually exposing yourself to the fear, under the supervision and guidance of a clinician, without performing the compulsion. Over time, the brain stops treating the thought like an emergency.

Stop Seeking Certainty - OCD thrives on the demand for 100 percent certainty. Recovery means learning to live with doubt, and choosing to act based on values instead of fear.

Work with a Specialist - Sexual OCD themes are often misunderstood, even by therapists. It’s important to work with someone trained in OCD treatment who will not shame, moralize, or mislabel what is happening.

At North Star Psychology, we treat all forms of OCD, including the ones no one wants to talk about. If you’re caught in an endless battle with intrusive sexual thoughts, we can help you find peace and clarity without fear controlling your life.

A thought is not always a reflection of who you are; OCD is lying to you. Let us help you learn the difference.