Gay OCD is the popular term for a type of obsession-only OCD in which a heterosexual male suffers from recurring, intrusive, anxious thoughts questioning his sexual orientation and his ability to fulfill a desired male role in society.
Gay OCD does NOT indicate that the sufferer has any actual desire for sexual contact with a man or that he would find such contact romantic or sexually exciting. Similarly, suffering from Gay OCD does not indicate homophobia or hatred of homosexuality in others.
Gay OCD is usually driven by feelings of insecurity regarding sexual performance, sexual desirability, lack of success in relationships, lack of interest in stereotypical male pursuits (eg, sports or automobiles), and/or interest in activities normally seen as female gendered (eg, fashion or ballet). Often the sufferer has had little romantic success or has noticed waning interest in his partner. They view unconscious homosexuality as a possible explanation for their 'failure' to fulfill a stereotypical male gender role.
Men suffering from gay OCD may additionally question whether they stare at other men in locker rooms or in photographs. Many sufferers have an interest in pornography and question whether their arousal while viewing depictions of sexuality is not in part due to images of male genitalia. Some try to test themselves by viewing pornographic images of men and women while monitoring themselves for signs of arousal. Inevitably, this makes the problem worse.
It is extremely rare for someone with gay OCD to actually try to engage in homosexual activity in order to see whether they actually enjoy it. Anyone considering this type of exploration should be discouraged until their fear of homosexual desire has been resolved.
You may also want to look up my page on OCD
Gay OCD is much easier to treat than many other forms of obsession-only OCD. Unfortunately, it is still more difficult to treat than forms of OCD with ritualized compulsive behavior (eg, washing or checking).
Treatment focuses on cognitive exercises to reduce intrusive thoughts while also resolving the patient's conscious insecurity regarding gender role fulfillment and / or sexual performance.
Treatment length varies with the severity of the patient's insecurities and their ability to question stereotypical roles. Patients who demonstrate intelligence and flexibility have a good prognosis. Treatment typically lasts 3 - 6 months.