People often throw the phrase "obsessive-compulsive disorder" (OCD) around as jokey shorthand for being excessively particular or high-strung, casting the disorder as a sort of innocuous, yet desexualizing, set of anxieties.

But OCD isn’t a quirk. It's a mental health condition that more than 2 percent of people experience at some point. It takes the random thoughts that flash through people's heads—that irrational fear of having done something wrong, or an unbidden, bizarre fantasy—and, instead of allowing them to quickly fade, forces them to the forefront of their minds in distressing spirals. Because these obsessions don’t respond well to reason, people with OCD develop rituals in an attempt to bring themselves relief from those anxieties. But that relief is fleeting, and people get stuck in this cycle of obsession and ritual. Many become dependent on a growing list of compulsions, which can become their own sources of anxiety and shame.

Obsessions and rituals can bleed directly into sex, as well. People with contamination obsessions often talk about fixating on the perceived dirtiness of genitals or bodily fluids and putting up hard limits on how they have sex. By some estimates, at least one in 10 people with OCD will also at some point develop obsessions about sex, constantly questioning their sexualities or worrying they might be developing harmful urges and building rituals into their relationships, their masturbation habits, their engagement with porn, to test or reassure themselves about their desires. Fears of being misunderstood—or actually dangerous—force some people with sexual obsessions to avoid intimacy altogether. Often, current or potential romantic partners who face the realities of OCD write those with the condition off as just too much.