OCD, Avoidance and Reproductive Healthcare
- Megan Hunt
- Sep 16
- 5 min read
Updated: Sep 18
This piece is part of our series for Sexual Health Awareness Week.
I’m sure nobody looks forward to their gynecology appointment, but for most, it’s a necessary–if not a bit uncomfortable–fact of life. However, for myself and I’m sure many others, mental illness has created invisible, but very real barriers, to sexual healthcare, and now, as a writer, I get to talk about it.
As someone living with Obsessive Compulsive Disorder (OCD), I’ve experienced severe and pervasive health anxiety (when the worry of illness or getting ill takes over your life) throughout many chapters of my life. Without any real evidence to support my fears, I’ve found myself certain of numerous medical concerns, from retinal detachment to autoimmune disorders to infertility to ovarian and cervical cancer.
When I discuss my obsessive thoughts about my own health, an assumption people often make is that I must be something of a nightmare in doctors' offices. There’s a common misconception that people with health anxiety use up a disproportionate amount of resources by seeking out medical attention for even the slightest of symptoms.
This might be true for some, and that’s by all means a difficult experience on its own, but it doesn’t reflect my own experience. Avoidance is a common compulsive behaviour among those with OCD, and this can include delaying or outright avoiding vital healthcare. I’ve described the experience as a twisted sort of Schrödinger's cat situation: while I feel certain of whatever affliction I’ve been obsessing over, getting a formal diagnosis marks the moment where my entire way of life changes as a result. Putting off a doctor’s appointment allowed me to stretch out the “before” phase, instead letting the worry eat away without any support. OCD often does this: it sends alarm bells through my body whenever I try to do the very things that can make me feel better.
In short, this is how I spent my entire adult life without ever visiting a gynecologist, even for the most basic wellness exams. Even on days where I felt overwhelmed by the weight of my intrusive thoughts, I couldn’t bring myself to book an appointment, instead turning to my rituals and compulsions to temporarily manage my distress. Hearing my friends discuss their own horror stories about medical professionals who didn’t properly listen to their concerns or made them feel unsafe only intensified my existing anxieties around reproductive healthcare.
Compulsive avoidance isn’t the only barrier I’ve faced as the result of OCD. Like many others with the condition, I’ve experienced sexual themes in my OCD in various contexts. While I don’t feel comfortable divulging too much information about this (and no person with OCD owes anyone an explanation for their intrusive thoughts!), I will say that it has presented challenges for me in terms of accessing healthcare.
The stigma surrounding OCD magnifies a lot of existing stigmas around sex, of which there are plenty. It’s hard enough to have candid conversations about pleasure, risk, orientation and relationships without intrusive thoughts on the subject matter. The truth is that my OCD themes shift and rotate in cycles, meaning there have been times over the years where my health anxiety was more or less manageable in comparison to other themes such as contamination, responsibility and harm. I look back and wish that I took advantage of these periods, but the truth is that even if I could overcome my health anxiety, I lived in fear that my OCD would inevitably become the topic of conversation. At best, I felt I was opening myself to the deep discomfort of being misunderstood, and at worst, I could be vulnerable to real harm.
I spent years hiding the extent of my OCD symptoms from everyone, even mental health professionals who were tasked with helping me overcome them. As impossible as it sounds, I was worried a doctor would be able to read my mind and bring all the intrusive thoughts I spent so much effort pushing away to the surface. For a long time, avoiding healthcare altogether felt like the only “safe” option for me– even though the end result was that I was forgoing preventative care and early detection opportunities that could literally be lifesaving.
I wish I could point to a single moment of awakening or turning point that changed everything for me. The truth is, my approach to handling my health anxiety has come in the form of baby steps, from adding myself to the family doctor waitlist in my area to getting much overdue blood tests to, finally, booking basic wellness exams.
By now, I’m sure you’re wondering if some horrible diagnostic fate was waiting for me on the other side of the exam table. Although I’m still early in this journey, so far none of the health outcomes I’ve been fearing the most have come true–but that doesn’t mean I don’t regret the risk I put my body through by ignoring necessary care for so long.
I’ve taken a very “yes, and” approach to my OCD recovery. Through some trial and error (of course, with the help of my psychiatrist), I’ve found a medication combination that lessens the intensity of my intrusive thoughts, making the challenging work of exposure therapy tolerable.
Although ERP (exposure response prevention, a key therapy modality for treating OCD) has been instrumental in my overall recovery, I credit values-based therapy, which focuses on what truly matters to me rather than solely on reducing symptoms, for helping me be more proactive about my health.
I strongly believe that reproductive healthcare is a human right, but for too many people, especially women and trans people, this right is riddled with threats and barriers in many places around the world. By reframing caring for my own reproductive health as a small but sincere way I can live my values, it makes the experience not easy, but manageable (and sometimes with OCD, that’s the best we can hope for).
If you’re struggling with similar experiences, please let my own experience be a reminder that while anxieties around medical care are valid, they don’t have to dominate your life. I feel deeply fortunate that (once again, so far!) I haven’t faced any serious health issues as the consequence of my avoidance, but the risk was certainly there.
Don’t be afraid to call a sexual health clinic or a provider that you already trust to discuss any barriers to access and how they might be alleviated. If you can, bring a person or an object that provides you with comfort to your appointment. Talk to any mental health professionals in your life about your concerns: there’s no shame in mentally preparing for an appointment with your therapist.
I can’t promise you the process will be easy, but I do know that your health is worth it.
This article has been sponsored by the Psychiatry Research Trust, who are dedicated to supporting young scientists in their groundbreaking research efforts within the field of mental health. If you wish to support their work, please consider donating.
