Identity as Fear and Perpetual Uncertainty: Transgender OCD

Children ranging from newborns to eleven-year-olds can view their surroundings in a neutral state of mind. Meaning, children have not yet pre-conditioned their minds to follow ideologies of pop culture. This gift of having a neutral state of mind allows kids to figure out what they like and dislike without any external influenced ideas. This may be about their favorite ice cream flavor, favorite color, or even what gender they are attracted to. As children grow up, they begin to identify more identities like gender. A person’s gender identity may change over time, but eventually, humans can figure out who they are. However, there is a condition called Transgender OCD (TOCD), in which someone becomes confused with their gender identity. 

OCD patients suffer from intrusive thoughts, which causes a great deal of anxiety and stress. To deal with high levels of anxiety and stress, OCD patients develop physical rituals to ease their anxiety. OCD can target any aspect of a person. In the case of TOCD, the patients have intrusive thoughts about gender, which causes anxiety and stress. According to Nathen Peterson, an OCD specialist, “Transgender is a word used to describe people whose gender identity differs from the gender they were thought to be when they were born.” TOCD may begin with a random thought like what would it be like to be a female or male? TOCD can also be caused by external forces. For instance, if someone views a video of someone coming out about their identity, someone may question their own identity. A person’s reaction to thoughts of being a different gender is what determines if they have TOCD. 

There are three common obsessions found amongst TOCD patients. The most obvious compulsion is their fear of being another gender. The second point is that people who suffer from TOCD don’t want others to find out about their thoughts. They are afraid of what others might say, so patients become antisocial, avoiding interactions by not dating, not attending social gatherings, nor talking to others. The third obsession found is that victims force themselves to believe what their brain is telling them. The orbital-frontal cortex (OFC), thalamus, and caudate nucleus are parts of the brain that are responsible for TOCD. Normally, the OFC sends a signal to the thalamus when the brain senses that the human body is in danger. The thalamus then takes the signal and acts as a pathway by sending strong signals to different parts of the brain to solve the problem. Usually, the caudate nucleus suppresses these signals so the body will not be overwhelmed by these signals (BBC, 2014). Unfortunately, for some people, the caudate nucleus is damaged and unable to suppress the signals. This leads to an overdrive of intrusive intensive thoughts, which may contribute to TOCD. Overwhelmed by these thoughts, these people may begin to believe the signals sent by the brain, even if they are frightened at the thought of being a different gender. 

Bentley Aquataa, a transgender OCD sufferer, shares some compulsions and symptoms that he faces on YouTube. Aquataa is hyper-aware of his body when out in public in fear that he may develop dysphoria. Dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and gender identity (NHS, 2020). Aquataa frequently searches for stories of trans coming out/detrans/TOCD/OCD stories. He takes online quizzes like “Do I have gender dysphoria?” constantly, taking them again and again in fear that he may have lied to himself with slightly different answers. He suffers from uneasy chest feelings, and checks the mirror often. He imagines himself as the opposite gender, questions if his OCD is real, and googles every little symptom. Aquatta is trying his best to live with his condition and is currently seeing a therapist to help him in his journey towards recovery.

Thankfully, there are treatments available for TOCD patients. Prescription medications specifically use different antidepressants like clomipramine, fluoxetine, and fluvoxamine to treat OCD. Antidepressant medications help OCD patients avoid intrusive thoughts. Therapists also recommend treatment exposure response prevention where patients are taught not to respond to their intrusive thoughts. Transgender OCD is a serious condition, and people should be mindful that their true selves is who they’ve always been. A random thought that appeared out of the blue does not define who they are. 



BBC, (2014, September 17). Science & Nature – Human Body and Mind – Root of obsession. Retrieved November 15, 2020, from

NHS, (2020, May 28). Gender dysphoria. Retrieved November 15, 2020, from

Petterson, N. (Director). (2020, September 28). Fear of being Transgender OCD (TOCD) [Video file]. Retrieved November 7, 2020, from

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