When OCD Makes You Question Your Sexual Orientation

I’m bisexual, usually hetero-romantic. I’m also gender fluid. For me this means I’m happy in my body and comfortable presenting as female, but spiritually and emotionally feel both male and female. While these identities are largely invisible, meaning I have straight cis privilege in my day-to-day, homophobia and transphobia have still left their mark on my internal landscape, my sense of self-worth. I didn’t begin feeling lust for men in the same way I did for women until my first sexual experiences in college. In high school, when I had crushes on boys and fantasized about girls, I thought my emotional and sexual attraction would always be at odds with each other. I feared I would never be able to have a satisfying relationship. Contrary to the highly politicized notion that sexuality is immutable, for the past decade or so I’ve found myself most physically interested in men, while still attracted to women and people outside of binary gender. This shift was not something I prayed for or willed to happen, and for all I know, my sexuality may continue to change over the course of my life. Attraction is complex and subjective, good fodder for a mental illness like obsessive compulsive disorder, that feeds on the impossibility of perfect certainty.

Gay and straight people alike often view bisexuality as a safety blanket before fully coming out rather than a valid identity in its own right. The therapist moderating the Coming Out support group I participated in during college insisted that my love for men was just a product of heteronormative conditioning, not my “true” sexuality. I grew up in a conservative Midwestern suburb in the era before terms like “non-binary” entered popular consciousness, when the only widely available narrative of non-cisgender identity was being born into the wrong body, then transitioning. When queer was still used as a pejorative toward those perceived to be gay rather than as an empowering umbrella term. The duality of my sexuality and gender would have been painfully confusing even if I didn’t have OCD, not because to be bisexual or genderqueer is to be inherently confused, but because our society still operates from a binary paradigm.

Obsessively questioning one’s sexual orientation isn’t a well-known manifestation of OCD, but it’s a common one. Rose Bretecher, a British journalist, has recounted her experience of intrusive sexual thoughts in The Guardian and in her memoir “Pure.” Rose, like many people with this form of OCD, is a straight woman who became convinced she was gay. The websites of organizations like the OCD Center of Los Angeles do mention that gay people with OCD, especially those with a new-found sense of stake in their identity, may obsessively ruminate over the possibility that they’re really straight. Also, that bisexual people with OCD often harbor the anxiety that they’re only attracted to one gender, usually not the one they’re dating. Still, gay and straight people are both reassured that their fear of missing out on their ideal partner makes them de facto Kinsey sixes and zeroes, reinforcing the idea of sexuality as a binary rather than a spectrum.

Reassurance merely sustains the OCD machine, which churns it up quickly in an endless data search. Checking that the oven is turned off or the toaster unplugged strengthens the desire to check again. People plagued by intrusive sexual thoughts will intentionally summon distressing mental images and scan their body for signs of arousal. For example: why did my eyes fall on that creepy old dude’s crotch? Was I checking him out? Why would I have looked if I wasn’t? Let’s think some more about his crotch and try to figure it out. Cue endless self-confirming thought loop. Only acceptance of uncertainty can ultimately switch off this misfiring alarm system.

While sitting with uncertainty, learning to dwell within it, is the basic tenet of the cognitive behavioral therapy used to treat OCD, information available online — the kind people search when desperately trying to make sense of things — frames intrusive thoughts as the opposite of sexual fantasy, anxiety as the opposite of sexual arousal, when the relationship can be muddier in reality.

Most OCD forums don’t discuss the way fear can mimic sexual excitement, producing an adrenaline rush which serves as further confirmation to the incessantly checking brain. Masturbating when you have untreated sexuality-themed OCD proves the common wisdom that if you try not to think about something, it becomes all you can think about. When I was unwell, allowing unwanted thoughts to break through provided an intense and terrifying sexual release. I believed this obsessive cycle to be indicative of repressed desire and assumed it was something all queer people experienced. When I realized I had OCD, I read articles which positioned obsessions as arbitrary by-products of excess neural activity. The human mind is indeed strange, relying on a delicate chemical interplay, but I don’t think internalized biphobia and cissexism can be teased apart from mental illness that easily in my case.

I grew up receiving negative messages about bisexual people from popular culture and peers. When I came out as bisexual at 21, my best friend asked me if I was really trying to tell her I was gay, voicing the doubt that already gnawed at me. (And why would I doubt my sexuality if there was nothing to doubt? Wouldn’t I feel the certainty other people projected?) I came out as a lesbian a few months afterward, having been advised by another unknowledgeable therapist that the obsessive thoughts would subside if I accepted my “truth.” They didn’t, and I continued to desire men as well as women. The OCD specialist I consulted a year later, while refusing to directly reassure me of anything, insinuated that my attraction to women wasn’t genuine but merely a product of my OCD. It felt easier and simpler to believe her rather than to tease apart intrusive, anxious thoughts from sincere feelings I’d had. The specialist also laughed at the idea that I might be trans, conflating my outward (and in part compensatory) femininity with my identity.

While I’ve stopped doubting my attraction to men and enjoyment of female presentation as I’ve grown healthier, my attraction to women and internal sense of myself as between-genders have not disappeared. I’ve come to love my fluidity, to draw on ambiguity as a source of compassion and spiritual strength rather than feeling lesser. Still, I’d like to live in a world where people who don’t fit into categories are believed rather than scoffed at, where mental health care providers are both adequately informed about OCD and sensitive to the nuances of identity.