Having OCD, in all probability, will not exactly enhance your love or sex life. If you have contamination phobias, of course, the pitfalls are obvious. Even if you don't, obsessions and compulsions, as you've probably learned the hard way, are not conducive to good relationships, romantic or otherwise. They tend to tax a partner's patience, for one thing, and prevent one member from participating in activities the other enjoys (indeed, OC symptoms may well prevent you from participating in activities you enjoy) and generally place a number of limits on a couple. The question is, what can you do about this?

Obviously, the first thing you'll want to do is get treatment, whether with medication, cognitive therapy, or one of the other methods we've discussed. However, while it's true that the more you do a thing, the less afraid of it you become, that's not necessarily the case when it comes to sex.

Fear of Illness

To a person who fears contracting a serious illness through sex, repetition, even with the same partner, will not always diminish the worry. Your mind may continue to sabotage the relationship by whispering into your ear (or your head, at any rate): So we're a couple. I don't know where she is 24/7. Can I trust her? Even so, what was she doing before we met? And on and on. And on.

So, here's the deal: Just as you would if you didn't have OCD, you need to talk. In fact, you probably need to talk more than you would otherwise. You may want to explain, for instance, your need to jump right up and shower afterward, if that is the case. You probably shouldn't let something like that come as a surprise to a new partner. In a fledgling romance, people are apt to feel self-conscious enough as it is. Try to have this talk early, rather than at the last moment; this will allow you to avoid having the strictures of your OCD intrude any more than necessary on your new relationship.

Of course, you'll want to talk about sexual history: disclosing yours and asking your would-be partner to do the same for you. That's just good sense, whether you have OCD or not. Certainly, if you're concerned about contagious illness, you'd be within your rights to ask your potential partner to have a blood test. (Of course, the same could be asked of you. If so, are you prepared to submit to one, yourself?) We think you should know the person fairly well before entering into a sexual relationship. And we believe in practicing safe sex. But we also understand that total reassurance might not be possible for you.

As for whether to believe what you're told, that's for you to decide. Chances are, your danger sensors are so out-of-whack at this point that you don't really trust yourself to make the right decisions. If that's so for you, perhaps you could ask a friend you trust whether she gets a good feeling about your potential partner's general honesty and character. You can also ask your therapist, or a family member. Then, ask yourself, and listen hard for the answer. You want to be careful, to protect yourself and others — and you should. But you also want to have fun, enjoy life's pleasures, maybe form a long-term relationship and even have a child, or children.

Sexual Anxiety and OCD

Sexual preoccupations are not uncommon in people who have OCD. Some people who have OCD are filled with worry that they might be gay. On the other hand, some people really are gay. Of these, some are not comfortable with that. In general, the kind of intense worry about possible homosexual impulses that accompanies OCD is more an irrational obsession than any routine developmental questioning of one's sexual orientation.

How can you tell whether you're gay or just panicked about the possibility that you might be? There isn't a physical test. You won't fluoresce under bright light or anything. But there are some guidelines psychologists use. The first thing you might want to ask yourself, however, is this: What if I am more attracted to people of my own sex than the other one?

Another thing to keep in mind: Most educated people today believe that sexuality occurs on a continuum. In other words, no one, really, is completely gay or completely straight. Most people fall somewhere along the spectrum. However, if the possibility that you might be homosexual is worrisome to you, then it's a legitimate problem, just as any worry would be.

How Do You Know?

While you can't necessarily know everything you want to know, just when you want to know it and with absolute certainty, there are a few guidelines you can use. You would also be well advised to talk with a therapist if you have concerns, not with the intention of trying to “cure” you if you are gay (such so-called “conversion therapy” has been discredited), but because this is the kind of information that most people would like to know about themselves.

In the meantime, here's the $64 dollar question: Do you want to date, or be intimate with, people of your own sex? If the answer is:

• And how! Then, chances are, you don't have to worry. You might be gay and if so, that's probably all right with you.

• No. I don't have a particular problem with homosexuality; it simply doesn't appeal to me personally, then chances are, you're not.

Confusion and worry can come in when your answer falls in between these extremes — and, for a lot of people, it will. If you have OCD and are constantly plagued by intrusive and unwanted sexual obsessions, things may be considerably trickier.

For some, attraction to members of their own sex will cause distress and anxiety. These folks may, indeed, be gay, but have a hard time accepting that because of social norms, upbringing, negative societal stereotypes, fear of discrimination, and so on.

Then there are those who don't feel attracted to persons of their own sex particularly, but find their minds repeatedly invaded with homosexual thoughts and impulses that disturb them.

Adding to the confusion is this: Virtually everyone — homosexual and heterosexual (and in between) — probably experiences bizarre sexual thoughts (again, both homosexual and heterosexual in nature) for no obvious reason. We don't know why this happens; we just know that it does.

The difference between a person who has OCD and a person who doesn't is that the thoughts won't bother the person who does not have OCD. They'll show up, the person will think, Well, that was weird, and go about her day. The person who has OCD or H-OCD, on the other hand, will obsess and obsess: What does it mean? Could I be gay? And, if not, why do I keep having these thoughts?

Next time, try allowing the thought to drift into your head and then quietly drift away. Or explore it. (“Hiya, thought. I want to do what with whom? Well, I don't think so, but all right; for the moment, instead of trying my hardest to push you away, I'll just go with it. Go ahead, thought. Do your worst.”)

Becoming Comfortable with Yourself

The truth is, if you feel genuinely attracted to members of your own sex, but this idea bothers you for the reasons mentioned elsewhere in this section, it's probably not an OCD issue. You still might benefit from some therapy, though, to help you feel more comfortable with yourself. (Like OCD, homosexuality is now believed to originate in the brain, not in one's early life experiences and certainly not in the choices one makes.)

If you're attracted to members of the opposite sex, but just can't seem to stop these intrusive, persistent homosexual worries, chances are it's an OCD issue and will respond well to treatment.