TOCD becoming real dysphoria? Losing my identity, need help

I am a 22 year old gay male (I hope...) I had never once questioned my gender identity until TOCD popped into my head 45 days ago as I was waking up. I have always been pretty masculine. I've never crossdressed or wished to be a woman, I've enjoyed things like building muscle, getting more body hair, finally being able to grow a beard, etc. After bottling up the TOCD for a month plus I saw my childhood psychiatrist last Thursday. He diagnosed me with OCD and prescribed me Zoloft ramping up to 200mg as follows: 5 days 50mg, 5 days 100mg, 5 days 150mg, then 200mg. This is my first day of 100mg and my 6th day of zoloft overall.

Up until Friday or Saturday, throughout the course of the OCD I had no actual symptoms of gender dysphoria, it was just pure obsession without cause, aside from sometimes feeling a little weird when looking in a mirror, which I attributed to my ever ballooning anxiety. However, 2 things happened after that:

1) I went down a very ill advised Reddit rabbit hole that led me to at least 2 or 3 people who had started out with TOCD and then come to the conclusion they were trans and begun medically transitioning.

2) I found out that a high school acquaintance of mine had come out as a trans woman earlier this year.

Since then my OCD (I hope) has exploded to previously unknown levels. Almost every moment of waking thought when I'm not otherwise occupied has been devoted to obsessing over whether I am trans. And alongside this, over these past few days some symptoms have developed that seem inescapably like gender dysphoria:

1) I find myself imagining myself being a woman in the future, especially when thinking about sexual relationships. It has become harder to imagine my future as being a man.
2) I have noticed a mild but weird sensation on my chest at times.

At the same time, I still very much like having a penis, and the thought of having a vagina weirds me out, as does thinking about all the makeup and body care stuff that women do.

I feel like my TOCD (I hope) is making me losing my actual identity as a man and making me develop some real dysphoric symptoms.

I know that straight people with HOCD often lose their opposite sex attraction while suffering from the condition. I can't find as much information about TOCD. Is this something that happens in TOCD - losing your previously firm identity as your birth gender? I really hope this isn't real dysphoria and is just OCD messing with my head.

Seven weeks ago as I woke up one day I had an intrusive thought "what if I am a woman"? Since then it has turned into a complete obsession that consumes almost every waking moment. I don't want to be trans but I'm becoming increasingly terrified I am. I've been diagnosed with OCD by my psych and an OCD specialist, but I met with my psych before things got more intense, and when I talked with the OCD specialist I forgot to mention a few things. I am supposed to start ERP in a few days. I found a few reddit posts by people who had or thought they had TOCD and turned out to be trans, and even one who got an OCD diagnosis and was prescribed meds for it. This terrifies me.

Indications that I have trans-themed OCD:

I never once questioned my gender identity before this suddenly popped into my head one morning as I was waking up. I was extremely comfortable as a man. In my more lucid moments I still am. I never identified more with girls and I never played as a girl in role play or video games.

This is the first thing I think of when I wake up and the last thing I think of before falling asleep. On bad days, I spend almost every waking moment thinking about it.

I spend hours a day reading everything I can find about TOCD.

I can't help but constantly check my appearance in mirrors and check how I feel about my genitals.

When doing these checking rituals, I never feel uncomfortable except for the OCD (I hope) asking me "what if you're uncomfortable and won't admit it?"

I'm gay and this provides a useful analogy. When I was coming to terms with this fact, I never had anything close to this sort of anxiety. And it didn't suddenly pop into my head overnight, it was a gradual process of realization over the course of about a year. And looking back (I first came to terms with being gay at 15 or 16 years old), I was able to find all kinds of memories dating back to 11 or 12 years old that were obvious in retrospect. Finally, I NEVER spent every waking moment obsessing over my sexual orientation like I am now doing with my gender identity.

Related to the previous - if I were offered a pill to make me straight, I would probably not take it. If I were offered a pill to make this trans stuff go away, I would take it without hesitation.

I have never cross dressed. A few days ago I shoved a rolled up sweatshirt under my shirt to simulate breasts. It felt weird and unnatural.

I like having a penis and am weirded out by the idea of having a vagina.

I like my body hair. I like having a beard.

When I visualize myself with girl's hair it feels weird and unnatural.

I like my deep voice. It bothers me when I think I sound too "girly" (which is OCD-generated nonsense anyway).

My name and he/him pronouns don't bother me. (Of course, a few seconds afterward, I start wondering if they /should/ have bothered me)

Magical thinking rituals - I'll have thoughts like "if I make it through this green light, then I'm not trans" or "if I get more than 20 mpg driving home, I'm not trans", etc. And then I'll do everything I can to make those happen.

At one point, for half a day my obsession temporarily changed from "am I trans?" to "am I non-binary?" During that half day, I felt absolutely certain that I was not transgender.

My psych diagnosed me with OCD a week ago. However, that was before the symptoms escalated.

A few days after starting the Zoloft, at one point I felt compelled to tell myself to stop denying it I'm clearly trans in denial and I need to get over it, come out, and plan my transition. I had about 20 minutes of peace after this (ERP effect maybe?) Then started what was possibly the worst anxiety attack I've ever had. For the rest of the day I was trembling and shaking, deep in total panic, and didn't have a single moment of clear thought. I don't think that would have happened if I were actually trans.

When I last looked at r/egg_irl and r/transforthememories, I related to none of the posts.

Last week I posted on r/asktransgender and all 3 respondents told me I had OCD and I was not trans. However, this was before the symptoms escalated.

The symptoms escalated shortly after I started Zoloft a few days ago, and I've read that for OCD sufferers the first week of SSRIs often results in worse OCD than before the meds.

My psych told me that gender dysphoria almost always first presents itself during either early childhood or puberty. I've asked my parents a ton of questions about what I was like back then and they are adamant that there is nothing in my past that would be a sign.

My symptoms are generally worst when I'm alone and unoccupied and far less bad when I'm busy interacting in a social situation. I imagine this is the opposite of what gender dysphoria is like.

I don't want to be trans. I want my old self back.

Before this started, I experienced a ton of what could be considered gender euphoria, especially over the last few years as I started looking and feeling less like a boy and more like a man.

Indications that I have genuine gender dysphoria:

The OCD (I hope it's OCD) comes and goes in waves. I've read that gender dysphoria comes and goes in waves.

I often don't like how I look in photos.

I really liked the color pink when I was in kindergarten.

I sometimes played with the girls during recess in first grade.

I HATED Star Wars with a passion when I was little because I thought it was scary.

I rarely call other guys dude/man/bro/etc.

I'm terrible at sports and was almost always the last one picked for teams in PE class.

I've had a number of mental conditions growing up including anxiety, ADHD, Aspergers, etc (no depression though). I've read that this is common for transgender people.

I looked at the user post histories of a bunch of creators of the TOCD threads on r/ocd on reddit, and I found that a few of them had later realized they were trans and begun transitioning. Some of them had mentioned histories of crossdressing or wishing to be the other gender, but for some I don't recall whether they said that, or there wasn't enough info. I am not going back down that rabbit hole to check.

I found out a few days ago that a high school acquaintance of mine had come out as transgender earlier this year, at age 22 or 23. We were pretty friendly with each other in high school and had a number of similar interests, and I never would have suspected this.

I didn't really like being on the skins team in "shirts vs skins" sports games as a kid.

I feel like I'm losing my identity as a man as the TOCD continues. Up is down, left is right, forward is backward, nothing makes sense anymore.

I feel a continuous anxiety on my bad days and the OCD (I hope) tells me this is dysphoria.

Apparently thinking you might be trans is in itself a sign you are trans.

A lot of trans women identify as gay men before realizing they are trans.

I like to cook.

I stumbled on a website called "turn me into a girl" that I assumed would be a gender swap photo filter - I was attempting to use it as reassurance. But I was wrong, after I pressed the button the website said I am a girl now and only girls would have wanted to press that button.

What if I only enjoy the stereotypically masculine interests I enjoy because I'm suppressing an inner female side?

Sometimes when I see men I find attractive I get an image in my head of me with them as a woman. I'm not sure if this is intrusive thoughts or dysphoria. Sometimes these thoughts cause me intense anxiety, sometimes they don't cause me anxiety.

Inconclusive but relevant:

I have found a bunch of questions on transgender websites and subreddits that people are supposed to ask themselves to see if they are trans. Stuff like the button test, would you rather become the opposite gender or have these thoughts go away, would you rather have your kids call you Mom or Dad, do you identify more with men or women in social situations, etc. For almost all of these questions (there are 1 or 2 that send my anxiety and self doubt into overdrive for whatever reason) my immediate and instinctive answer is the one that aligns with being cis. However, doubt almost always pops up after I answer that way and I wonder if I am only answering the way I am because I am deep in denial.

I have had some really weird sexual fetishes in the past. For a while I was obsessed with men wearing specific types of sports equipment, for a while I was obsessed with ballgagged men, for a while I was obsessed with amputees, for a while I was fascinated by hardcore BDSM. At one point I read an article about a man with testicles but no penis and it seemed mildly fascinating.

It was three days after onset before I worked up the courage to type "intrusive thoughts transgender" into Google and I found an article about TOCD, and since then I've thought/hoped this is TOCD. Before that I thought I was stuck being trans for the rest of my life.

When the initial intrusive thought popped into my head, I think there was a delay of about a minute before the initial waves of panic and anxiety appeared. But my memory is very fuzzy on this.

I have had a few OCD episodes in the past year but none were nearly as intense or long lasting as this one.

I felt a lot better the last few days, but then I stumbled on the "indirect dysphoria" thing again and it's freaking me out. I was pretty flat emotionally during high school because of ADHD meds. I stopped taking those meds the summer before college and I was very quickly a new man. But the OCD is telling me it might be indirect dysphoria...

Anyone?????? This is making me crazy. I don't want to be trans, I don't want to be a woman, I just want to be back to being happy as a man without this nonsense obsessing the way I was until 8 weeks ago. Spent my whole life admiring male role models, wanting to be more masculine, liking my male characteristics, bonding much more closely with men than with women, etc. I still feel that way deep down (I think -- OCD makes it hard to tell because every definitive thought is answered by 10 immediate "what if"s) but the OCD is scrambling my brain so much that it's hard for me to tell anything anymore. Is it really possible to LOVE your gender identity as a man and suddenly wake up trans? I hate this, I just want my brain back.

I see no way out of this, it feels like I'm either going to be stuck with this OCD for life and then my life is ruined or I'm going to turn out to be trans and in denial and then my life is ruined because I don't want to be a woman.

I'm also worried that I have some combination of Borderline Personality Disorder, Bipolar Disorder, and Klinefelter Syndrome. All the doctors I've seen said no but I don't fully believe them...

The only way I see out of this is to go on TRT (I do genuinely believe, OCD notwithstanding, that I have abnormally low T for my age; it would explain a lot) and let the OCD dissipate once I'm happy with the effects and realize that. (But what if... ughhhhh)

This kind of back and forth uncertainty cycle is normal for any kind of OCD.

Even if I'm struggling with it myself (with no psychiatric professional help) the usual conclusion is that if it feels like the end of the world and you'd rather die to be trans, then you are probably not trans.

Listen to your doctors and keep going to therapy/taking the meds. Don't feed the obsession.

Yeah seriously bro, unless you're asking for advice on CBT/ERP/whatever methods, the best thing you can do for yourself is to stop posting here. Reassurance-seeking will make your pain so much worse.

throwaway5487 wrote:Yeah seriously bro, unless you're asking for advice on CBT/ERP/whatever methods, the best thing you can do for yourself is to stop posting here. Reassurance-seeking will make your pain so much worse.

Reassurance is like cotton candy- tastes good then it evaporates. I think posting here is good, but at a certain point, if ALL you are seeking is reassurance, as if it was a drug and you need your fix, perhaps stepping back from forums a while might be a good thing.

youllgetoverit wrote:This kind of back and forth uncertainty cycle is normal for any kind of OCD.

Even if I'm struggling with it myself (with no psychiatric professional help) the usual conclusion is that if it feels like the end of the world and you'd rather die to be trans, then you are probably not trans.

Listen to your doctors and keep going to therapy/taking the meds. Don't feed the obsession.

Agreed. I'm Bi, and while I'm not Trans, I'm... different. 'non-binary' has been so overused lately in the Twittersphere, that I'm getting reluctant to call myself that, but I do not 'feel' particularly male, although I am.

I have never wanted to die, rather than be the things I've struggled with. And a part of me actually resists the idea of being straight and 'normal'. Just because I wish I wasn't the things I am, doesn't mean I'm willing to take a 'cure' for them, either. For me, that's even more dreadful, than the things I don't like in myself. It's a tenuous, fine distinction, but one that I think separates OCD from not-OCD.

Hey man, sorry to hear you are suffering so much. I have this OCD form too and it is truly awful, I hate and despise it and it is making my life a misery.

I think you need to stop looking for the answer to every single point or question about this topic as it is just fuels the OCD and keeps it going. Hopefully through therapy you will be able to improve.

tormentedman97 wrote:I am a 22 year old gay male (I hope...) I had never once questioned my gender identity until TOCD popped into my head 45 days ago as I was waking up.

I had a similar experience, I was lying in bed and the thought "I'm a transsexual" just popped into my head.

1) I went down a very ill advised Reddit rabbit hole that led me to at least 2 or 3 people who had started out with TOCD and then come to the conclusion they were trans and begun medically transitioning.

Try and avoid this man, this is just fuelling your ocd and anxiety. You don't know that they definitely had OCD and they were probably just in denial and thought it was OCD, rather than actually having OCD.

2) I found out that a high school acquaintance of mine had come out as a trans woman earlier this year.

Ok but that doesn't make you trans. They are a separate person to you.

Since then my OCD (I hope) has exploded to previously unknown levels. Almost every moment of waking thought when I'm not otherwise occupied has been devoted to obsessing over whether I am trans.

Try and accept the possibility, when the thoughts come up, say "maybe I am, maybe I'm not' and then try and get on with our day

And alongside this, over these past few days some symptoms have developed that seem inescapably like gender dysphoria:

1) I find myself imagining myself being a woman in the future, especially when thinking about sexual relationships. It has become harder to imagine my future as being a man.
2) I have noticed a mild but weird sensation on my chest at times.

Having a chest sensation does not make you trans, a sensation is just a sensation and people have all kinds of sensations all the time.

I get bodily sensations too and it has scared me so I understand what kind of place you're in.

At the same time, I still very much like having a penis, and the thought of having a vagina weirds me out, as does thinking about all the makeup and body care stuff that women do.

Ok I know reassuring you is bad but this all sounds very cis to me


I really hope you can improve through your therapy buddy as it sounds like you are suffering a lot from this wretched disorder.