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Fred Penzel, a psychologist on Long Island, N. The overwhelming majority of e-mails I get are on this particular type of OCD.

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He soon developed an out-of-control obsession with watching gay pornography to check if it could arouse him. He says it did not, but the uncertainty remained and became so extreme he considered suicide.

He adds that, once or twice while watching gay porn, he did have an orgasm.

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I went further down the rabbit hole. I knew I always wanted to go back and look at women. Women got me more excited than men did. Michael never attempted to have sex with another man, but, like watching porn, many experiencing HOCD do engage in sexual activity as a form of checking, behavior that throws their doubt into overdrive.

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Monnica Williams moved to Kentucky five years ago, she says she was the only mental health practitioner in the state who specialized in OCD. Until fairly recently, some online forums for OCD prohibited people from posting about HOCD because of the overwhelming skepticism as to whether it was real. Yet they keep having these unwanted thoughts about it. I think a lot of people commit suicide. The thoughts grew even stronger.

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Richard Montoro, a psychiatrist at the McGill University Sexual Identity Centre in Montreal who specializes in helping LGBT people come to terms with their sexual orientations and gender identity, saw his first case of HOCD two decades ago; a man came to him convinced he was gay because of the shape of his eyebrows.

By the end of the session it was clear to Montoro the man was suffering from OCD.

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He considers himself an ally of the LGBT community, namely because of this experience. Gay people, however, are also proportionately affected by what might be called straight OCD, consumed by thoughts they might be heterosexual — Penzel has treated several such patients, including one lesbian who had a wife and children and came close to ending her marriage.

In all cases, symptoms tend to develop rapidly, triggered by a precise moment, such as seeing an attractive actor in a movie, having bad sex with your spouse, reading a news item about gay rights, or learning of a friend or family member coming out of the closet.

Many well-intentioned but uninformed therapists, believing their patients are merely in the closet, will encourage them to get out there and try it. For most, a mixture of cognitive and behavioral therapy is the most effective treatment because it forces patients to mentally engage with their fears until reaching the point where those fears begin to feel benign.

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Antidepressants and SSRIs are often effective in treatment. In the most severe cases, brain surgery may be required. But it is really not like before. In the past you would have been relaxed, maybe having a few beers. The perfect environment for everything to be in working order.

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Let me tell you, if you are stressed, nothing down there works very well! It is only a matter of time before these thoughts are running your life. Maybe you are giving off some sort of a gay vibe and never knew it!

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If any of this is familiar to you, it screams of intrusive thoughts. You will not be gay.

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  • HOCD or denial?

You are just afraid you might be and are reacting to the thought as if it is reality. This is the question I get asked the most.

HOCD – How do I know I am not gay and how do I overcome HOCD

HOCD is characterised by a nagging doubt. The doubt arises because the thoughts in your head are so foreign to who you are as a person, and because you attach some significance to the thoughts, you start to believe that they must mean something. Without having a good understanding of how your brain works, you might not fully understand what is happening and therefore find it hard to dismiss thoughts relating to HOCD.

Your brain is wired to keep you out of harms way, which means that it shall pay more attention to the bad things than the good experiences in your life — your brain does not need to protect you from good things.