I have never heard of a case of someone with OCD about being a pedophile or killer realizing they really were one. However, mental health professionals have encountered individuals with HOCD who have come to the conclusion that they were gay. Reassurance doesn't help in any of these cases. It's common for mental health professionals to try reassuring a patient in some way, especially earlier in treatment, but ultimately the reassurance doesn't treat the OCD. The OCD is treated by eliminating compulsive checking, researching, and analyzing, and tolerating the uncertainty in the process. If I understood your email correctly, what you are struggling with the most is what seems to be a contradiction between (1) how mental health professionals might tell a person with HOCD that they don't think he's gay, and (2) the idea that someone with HOCD could in fact be gay. I think the simplest way to explain this contradiction is that what professionals might say to someone about his sexual orientation would be their impressions of that person, specifically. I can't speak on behalf of other professionals, but I assume this is what would be intended. On the other hand, the information you've read about HOCD is about HOCD in general, for all the different people who have it. Some of these people are gay and some of them are straight and some are in the middle. All of these people are unsure of their sexual orientation, all of them are frantically trying to figure out their sexual orientation, and all of them are terrified of making a mistake in either direction -- by thinking they're gay or thinking they're straight. The problem is that when people have HOCD and they're constantly engaged in compulsions, they can feel so confused that they truly don't know what's real. Nothing anyone tells them will convince them. If someone tells them they are straight, they just worry that that person is wrong, because they are afraid of making a mistake in either direction. OCD can be incredibly, profoundly confusing and torturous. People with HOCD constantly try to figure out their sexual orientation. They analyze and ruminate about every sexual and romantic feeling and thought they've ever had. They even try to have feelings and thoughts on purpose to try to figure out the answer. But what happens is that all of this analysis and rumination just make the person ever more confused and even more scared, and makes it impossible to actually figure out what's real. The more confused and scared they get, the more they analyze and ruminate. It's a horrible, torturous cycle. The way we treat HOCD isn't by trying to answer the question, since trying to answer the question is what fuels this horrible cycle. Instead, the way we treat it is by working on eliminating the analysis, mental tests, research, and reassurance-seeking. Once a person eliminates this, things gradually become clearer, and they can get a picture of what their sexual orientation actually looks like. In other words, in order to eventually gain an answer to the question, the person has to stop trying to figure out the answer. This may sound simple, but it can actually be an incredibly difficult, scary, and complicated process. Hi I have just come across this article online from Reddit from an OCD therapist by the looks of things. Is that a therapist say you can HOCD and realise you are Gay. So confused.