Sexual orientation obsessive–compulsive disorder

Sexual orientation OCD (also known as SO-OCD) is a form of primarily obsessional obsessive–compulsive disorder characterised by intrusive thoughts and compulsions related to doubts about one's sexual orientation.^[1] OCD was initially categorised as an anxiety disorder. However, in DSM-5 published in 2013, it has been reclassified into its own distinct category. According to the latest edition of DSM, obsessions are unwanted, repetitive thoughts that cause significant anxiety. In response, the individual often tries to neutralize these thoughts by performing specific actions, which is known as compulsions. Patients feel compelled to practice these rituals, either to relieve anxiety or prevent something bad from happening. In SO-OCD, the obsession takes the form of intrusive doubts about one’s sexual orientation, leading to compulsive behaviours to seek reassurance.^[2] Although SO-OCD is not mentioned as such in the chapter "Obsessive-Compulsive and Related Disorders" of the DSM-V, the chapter on "Paraphilic Disorders" briefly mentions it when differentiating pedophilia from Pedophilia-OCD: "there are occasional individuals who complain about ego-dystonic thoughts and worries about possible attraction to children. Clinical interviewing usually reveals an absence of sexual thoughts about children during high states of sexual arousal (e.g., approaching orgasm during masturbation) and sometimes additional ego-dystonic, intrusive sexual ideas (e.g., concerns about homosexuality)".^[3]