My cisgender OCD (telling me I’m not trans) is back for the first time since I did my full course of gender-OCD-focused ERP. It hurts. It makes it harder to have a healthy relationship with my body, a healthy sense of self, respect for all I’ve done to get as far as I’ve gotten as a transgender woman. I can really feel the difference the ERP made in the severity of symptoms and in how I handle them, and yet here I am again, dealing with obsessive and intrusive thoughts that I’m really a man. I wish more people understood just how painful this is.

Looking back, I realize I’ve had OCD since I was 7. though I wasn’t diagnosed until I was 30. As a kid, I was consumed by fears I couldn’t explain: "What if God isn’t real? What happens when we die? How do I know I’m real?" These existential thoughts terrified me, and while everyone has them from time to time, I felt like they were consuming my life. By 12, I was having daily panic attacks about death and war, feeling untethered from reality as depersonalization and derealization set in. At 15, I turned to drinking, spending the next 15 years drunk, trying to escape my mind. I hated myself, struggled with my body, and my intrusive thoughts. Sobriety forced me to face it all head-on. In May 2022, I finally learned I had OCD. I remember the exact date: May 10th. Reading about it, I thought, "Oh my God, this is it. This explains everything." My main themes were existential OCD and self-harm intrusive thoughts. The self-harm fears were the hardest: "What if I kill myself? What if I lose control?" These thoughts terrified me because I didn’t want to die. ERP changed everything. At first, I thought, "You want me to confront my worst fears? Are you kidding me?" But ERP is gradual and done at your pace. My therapist taught me to lean into uncertainty instead of fighting it. She’d say, "Maybe you’ll kill yourself—who knows?" At first, it felt scary, but for OCD, it was freeing. Slowly, I realized my thoughts were just thoughts. ERP gave me my life back. I’m working again, I’m sober, and for the first time, I can imagine a future. If you’re scared to try ERP, I get it. But if you’re already living in fear, why not try a set of tools that can give you hope?

so I need to get back into ERP, but it’s so hard to manage these thoughts and learn to deal with them. like I swear my mind has to make everything about it. Like every time I clean my room, my mind’s like yup make sure it’s clean so when your parents find you, or something so stupid like if I get a headache, my mind convinces me that I like the pain and that that’s why I get my thoughts because I actually want to do it. It’s so exhausting. Because I know I would never want to take my life and I treasure my life so why does it do it to me? It’s hard to comprehend the fact of these thoughts too because I don’t know many people with this exact theme. It’s such a scary feeling. And I’m constantly questioning whether I have actual depression or if it’s just my OCD. Yes I have been diagnosed with suicidal OCD, but my mind still tries to convince me otherwise. I just don’t know how to let these just sit and pass without panicking.

I think when people are saying OCD is egodystonic is really triggering me and I was just wondering if this has happened to anyone else? I’m going through a really bad relapse and right now I’m trying to figure out if my thoughts are truly egodystonic, like I how do I know I won’t act on them, how can I trust my emotions and everything. I feel really confused and I feel like I don’t know who I am anymore or how I carry on with life because it’s so long and I’m so unsure of everything that’s going on in my head. Like how do I know that this is OCD and true desires/urges. I’m so confused.