By Taneia Surles, MPH, NOCD
The LGBTQIA+ community has higher rates of mental health challenges and needs for mental health services than non-LGBTQIA+ people, yet many of their experiences are still underrecognized. Bisexual people, in particular, often navigate a double burden: the internal stressors of mental health conditions and the external invalidation of their sexual identity. Highlighting these underrepresented experiences is crucial to helping people find inclusive, affirming care from culturally competent mental healthcare professionals.
Obsessive compulsive disorder (OCD) is a condition marked by a cycle of intrusive thoughts and compulsions that can cause significant distress. OCD often latches onto what a person values the most—identity, relationships, and acceptance—making LGBTQIA+ people especially vulnerable to themes that target those areas.
One area where OCD can have a unique impact is around sexual identity, especially for bisexual people, whose experiences are often misunderstood or dismissed.
Bisexuality refers to a sexual and/or romantic attraction to more than one gender. Bi+ people often face bisexual erasure (also known as bisexual invisibility), the denial or rejection of bisexuality as a sexual identity. Ultimately, this can have a negative effect on their mental well-being.
For bisexual people, OCD doesn’t just cause internal distress—it can also amplify the external invalidation they’re already experiencing.
Mental health impacts of bi-erasure
Bi-erasure can come in many forms, including:
- Calling bisexuality a “phase.”
- Assuming a man and woman together must be straight.
- Asking bi+ people to prove their bisexuality.
- Claiming bi+ men don’t exist and that they’re actually gay.
- Minimizing bi+ people’s relationships.
Bisexual invisibility can have a detrimental effect on a bisexual person’s mental health. “Our identities are ever-evolving and somewhat fragile,” says April Kilduff, MA, LCPC, LMHC, LPCC, LPC, a therapist at NOCD. “To have a sense of yourself and then have other people or society at large deny your identity exists could wreak havoc on someone’s sense of mental health.”
Research reveals that bi-erasure is a contributing factor to mental health disparities, with bisexual people having higher rates of anxiety and depression than straight, lesbian, or gay people.
When your identity is constantly being invalidated by society, it’s easy for OCD to weaponize that doubt against you, which is common for those with sexual orientation OCD (SO-OCD).
Sexual orientation OCD and relationship OCD
Two OCD subtypes that can intertwine with a bi+ person’s sexual identity are SO-OCD and relationship OCD (ROCD).
SO-OCD involves intrusive thoughts or compulsions revolving around your sexual orientation. This subtype isn’t the fear of having any particular sexual identity, but rather the doubt itself and the distress that comes with not having absolute certainty. In contrast, ROCD focuses on fears about close personal relationships—romantic or platonic.
“SO-OCD can often co-occur with ROCD when the person is in a relationship,” says Kilduff. “That can look like the bisexual person feeling like they must be absolutely certain of their orientation before they can interact sexually in their relationship, or massive worries that they’re lying to their partner about their sexuality.”
Here’s how symptoms of SO-OCD and ROCD can show up for bi+ people:
- Distress when in a same-gender relationship: “Does this mean I’m not bi?”
- Distress when in a different-gender relationship: “Everyone thinks I’m straight now—am I lying?”
- Constant mental checking of sexuality.
- Seeking reassurance from friends, online forums, or chat rooms that your fears aren’t real.
How OCD targets uncertainty in bisexual identity
OCD is nicknamed the “doubting disorder,” as the condition exploits uncertainty and personal values, which, for bi+ people, can be even more difficult to deal with as their identity is already being called into question.
“OCD is all about uncertainty and the notion that we can somehow eliminate it entirely, which is simply not true,” explains Kilduff. “When someone has values of honesty, sincerity, connection, etc., OCD can make it seem like they really must find the answer to the question of their sexuality. It hates the idea that a person might be lying or concealing their ‘true’ sexuality.”
Some themes of SO-OCD that bi+ people may experience include:
- “What if I’m not really bi?”
- “What if I’m lying to myself or others?”
- “What if I’m just seeking attention?”
These intrusive thoughts can result in compulsions done to “figure out” or “prove” your bisexual identity.
Identity-affirming OCD treatment
Bi+ people experiencing SO-OCD and ROCD can seek help for their symptoms with exposure and response prevention (ERP) therapy. The evidence-based treatment helps you confront your fears about your sexual identity and relationships without resorting to compulsions to find certainty.
“The best way to learn to tolerate uncertainty is to practice sitting with it instead of trying to solve it all the time and to give up the compulsions related to their SO-OCD or ROCD,” says Kilduff. “Doing ERP therapy provides exactly that opportunity.”
Understand that your bi+ identity doesn’t need to be proven to OCD or anyone else. Your identity isn’t invalidated by OCD’s fear-based questioning about your sexuality.
Finding support
If you believe you have SO-OCD, ROCD, or a combination of both, there are LGBTQIA+-affirming therapists with specialized training in ERP who can help you separate OCD-related fears from genuine questioning of your sexual identity. Finding culturally responsive OCD treatment can help you better understand how identity and OCD interact with one another.
“Culturally responsive care is essential because of the mental health damage that can be done when culture is not affirming of someone’s identity,” says Kilduff. “A good therapist will be affirming of their clients and will know to look at their clients’ lives in the greater context of culture and society.”
OCD is a complex condition to deal with daily, but know there’s support available to help you overcome your fears. Your identity is valid, even when OCD tries to convince you otherwise.
Resources
Sources:
Mental Health Care Needs and Experiences Among LGBT+ People
Sexual Orientation OCD (SO-OCD): Signs, Symptoms, and Treatment
The post OCD & bisexuality: Navigating bi-erasure and invalidation appeared first on International OCD Foundation.
