Teen Sexuality and OCD

As many as 25 percent of teenagers with OCD have intrusive thoughts of a sexual nature. Again, this happens to both girls and boys. When these involuntary thoughts assault a teenager with OCD, they often bring the sufferer shame, embarrassment, and confusion. Obsessions of this type can be triggered in the teenager when she sees something as simple and innocent as two people expressing appropriate affection in public, like hugs, kisses, or holding hands. Similar scenes in movies and on television can have the same effect.

I can't even look at a girl or really have much in the way of relations because of obsessive fears being triggered. Every girl I find attractive, my mind will immediately go to an image of my sisters or my mother. I will conclude that they resemble them in some way, and thus it's immoral to pursue this. I can't indulge in any kind of sexual expression or activity because of this.

Sexual anxiety can also be triggered in the OCD teen by his internal thoughts, with or without a stimulus. For example, when the image of a pretty girl occurs to a teenage boy, his OCD can cause him to imagine that girl engaged in “disgusting” or inappropriate sexual acts. The main point for parents to understand is that these obsessions, like any other OCD symptoms, are involuntary; your teenager has no control over when and if these thoughts come into his mind. Neither does he have the desire to engage in the acts that are causing him so much anxiety. Most often they are repellant to him. As the thoughts keep recurring, his shame and discomfort intensify.

Gender Instability

A heterosexual teenager with OCD will often develop an irrational fear that he is, or may become, homosexual. This very common obsession for teenage boys with OCD can prevent an adolescent from joining a sports team or any activity that puts him in close proximity to his peers. Locker rooms can be an especially trying environment for boys dealing with this issue. Here is one heterosexual thirteen-year-old boy with OCD sharing his experience dealing with his sexuality obsession and the resulting avoidance compulsion.

If I looked at a guy's butt, groin, or face, I'd get a picture in my mind of kissing him, or having sex with him. So I looked away, or at the ground. A friend of mine asked why I always did that. I said because I'm shy.

Some of the other issues relating to male gender roles that provide fodder for teenage boys with OCD include fears of their own physical inadequacy, intellectual inferiority, and potential subordination to women. If a teenage boy with OCD has a belief system that includes a very “macho,” ultraresponsible model of manhood, he may be more susceptible to self-doubts and fears in this area.

Since adolescence is already a time of huge emotional and hormonal growth and changes, it should not surprise parents to learn that gender roles and sexuality issues are common areas for OCD-related obsessions.

OCD specialist and psychologist Dr. Fred Penzel, author of Obsessive-Compulsive Disorders: A Complete Guide to Getting Well and Staying Well, addressed this issue on the OCF Teens' Organized Chaos Web site in an article titled, “The Boy Who Didn't Know Who He Was”:

One of the really maddening qualities of OCD is that it can make a person doubt the most basic things about himself — things no one would normally doubt. Even one's sexual identity can be questioned…. Doing compulsions, such as repeated questioning, avoiding things, looking for reassurance, and checking can work in the short run, [but] this is what keeps the problem going. By staying away from the things that make them anxious, sufferers only keep themselves sensitive to these things…. A favorite saying of mine goes, “If you want to think about it less, think about it more.”

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