Some individuals with obsessive-compulsive disorder experience intrusive sexual thoughts of a troubling nature. This form of OCD falls under the “unacceptable/taboo thoughts” subtype, as opposed to the symmetry/arranging, doubt/harm and contamination subtypes. This is a form of OCD associated with pure OCD, or OCD without compulsions. These sexual obsessions involve unwanted and disturbing thoughts about engaging in inappropriate sexual activity, such as sex with animals, children, individuals of the same sex when the OCD sufferer is heterosexual, religious figures or family members.
About a quarter of those with OCD suffer from sexual obsessions. The number may even be underestimated, since it is likely that many of those who suffer from these thoughts are reluctant to admit their embarrassing thoughts. These sexual obsessions seem to be equally divided among men and women. Many heterosexual people experience intrusive homosexual thoughts, and begin to believe that they are possibly covert homosexuals. These are distinct from fantasies, since fantasies are conducted voluntarily and for enjoyment, whereas obsessions are involuntarily and disturbing to the individuals. Guilt, lust, anger and disgust are frequently associated with these obsessions.
This is sometimes known as sexual orientation obsessions in OCD, or SO-OCD. Some have referred to it as HOCD, or “homosexual OCD.” Approximately 10 percent of those with OCD experienced unwanted obsessions associated with homosexual activity. These individuals are terrified that they might harbor unconscious sexual desires that they have repressed. It must be understood that this is not a form of internalized homophobia. It is true that there are individuals who experience sexual desire for the same sex and feel bad about it, but those with SO-OCD experience no sexual desire for the same sex. Instead, they simply have intrusive thoughts and images in which they picture themselves having sex with someone of the same sex.
One of the most frightening forms of SO-OCD is one associated with thoughts of pedophilia. Individuals with this form of OCD are terrified that they are attracted to children. Some people with this form of OCD become so distressed that they become suicidal. Such individuals may compulsively avoid children because they are afraid that they will molest these children even though they do not have sexual desires for them. Instead, intrusive images and thoughts force their way into the individual’s head that involve having sex with children.
It is important to understand that these individuals are not pedophiles. They neither molest children, nor do they have sexual desires for children. Understandably, many of those with OCD are afraid to report these symptoms to mental health professionals, since they fear being misunderstood and perceived as genuine threats to children. This is known as pedophile OCD or POCD.