Selective serotonin reuptake inhibitors (SSRIs) are used, especially with exhibitionists, non-offending pedophiles, and compulsive masturbators. They are proposed to work by reducing sexual arousal, compulsivity, and depressive symptoms. However, supporting evidence for SSRIs is limited.

According to the World Health Organization, fetishistic fantasies are common and should only be treated as a disorder when they impair normal functioning or cause distress. Goals of treatment can include elimination of criminal activity, reduction in reliance on the fetish for sexual satisfaction, improving relationship skills, or attempting to remove deviant arousal altogether. The evidence for treatment efficacy is limited and largely based on case studies, and no research on treatment for female fetishists exists.

Cognitive behavioral therapy is one popular approach. Cognitive behavioral therapists teach clients to identify and avoid antecedents to fetishistic behavior, and substitute non-fetishistic fantasies for ones involving the fetish. Aversion therapy can reduce fetishistic arousal in the short term, but is unlikely to have any permanent effect.

Antiandrogens and selective serotonin reuptake inhibitors (SSRIs) may be prescribed to lower sex drive. Cyproterone acetate is the most commonly used antiandrogen, except in the United States, where it may not be available. A large body of literature has shown that it reduces general sexual fantasies. Side effects may include osteoporosis, liver dysfunction, and feminization. Case studies have found that the antiandrogen medroxyprogesterone acetate is successful in reducing sexual interest, but can have side effects including osteoporosis, diabetes, deep vein thrombosis, feminization, and weight gain. Some hospitals use leuprolide acetate and goserelin acetate to reduce libido, and while there is presently little evidence for their efficacy, they have fewer side effects than other antiandrogens. A number of studies support the use of SSRIs, which may be preferable over antiandrogens because of their relatively benign side effects. None of these drugs cure sexual fetishism, but they can make it easier to manage.

Relationship counselers may attempt to reduce dependence on the fetish and improve partner communication using techniques like sensate focusing. Partners may agree to incorporate the fetish into their activities in a controlled, time-limited manner, or set aside only certain days to practice the fetishism. If the fetishist cannot sustain an erection without the fetish object, the therapist might recommend orgasmic reconditioning or covert sensitization to increase arousal to normal stimuli (although the evidence base for these techniques is weak).

Pharmacological treatments can help people control their sexual behaviors, but do not change the content of the paraphilia. They are typically combined with cognitive behavioral therapy for best effect.

Anesthesia fetish is considered edgeplay when realised outside the boundaries of fantasy, and may result in various degrees of harm, or death. Fantasies are elaborated by the viewing of images and reading of stories of anesthetic inductions. Edgeplay may involve obtaining and scening with various anesthesia-related paraphernalia—usually anesthesia masks for breathplay, the acquisition of anesthetics for anesthetizing others or being anesthetized oneself, and the occupation of a medical setting or environment for the same practice.

Some anesthesia fetishists who seek to be anesthetized may feign or induce medical conditions in an attempt to obtain general anesthesia from medical personnel. This is considered safer than playing with anesthetic agents outside of a medical setting, but may nevertheless be an abuse of all concerned.

Acrotomophiles may be attracted to amputees because they like the way they look or they may view the amputee’s stump as a phallic object which can be used for sexual pleasure.A small number of Acrotomophiles may enjoy the idea of dominating the amputee during couples play and they may also become aroused with the thought of having to take care of an amputee.

Macrophilia is a fascination with or a sexual fantasy involving giants, more commonly expressed as giantesses (female giants). It is typically a male fantasy, with the male playing the "smaller" part—entering, being dominated, or being eaten by the larger woman. Others involve partners who naturally have a significant difference in size.

Some rubber and plastic fetishists have an affinity for diapers and rubber pants. In the case of disposable diapers, this attraction would be to their crinkly plastic backing. In the case of cloth diapers, it would be towards the latex or pvc of the pants worn over them.

Spectrophilia is a fetish that is classified as the paraphilia in which one is attracted to ghosts or spirits. Spectrophiliacs fantasize about ghosts and often imagine scenarios involving sexual events between themselves or others and spirits.

The Internet has enabled people with this relatively rare paraphilia to discuss the subject and exchange anesthesia-related multimedia.

Spectrophilia is sexual attraction to ghosts or sexual arousal from images in mirrors, as well as the phenomenon of sexual encounters between ghosts and humans.

Acrotomophilia (from the Greek ἀκρότομος "having the top cut off" (from ἄκρον "akron" "extremity" and -τομος "-tomos" from τέμνω "temno" "I cut") and φιλία "philia" "love") is a paraphilia in which an individual expresses strong sexual interest in amputees. It is a counterpart to "apotemnophilia", the sexual interest in "being" an amputee.

Nichols (2006) compiled some common clinical issues: countertransference, non-disclosure, coming-out, partner/families, and bleed-through.

Countertransference is a common problem in clinical settings. Despite having no evidence, therapists may find themselves believing that their client’s pathology is "self-evident". Therapists may feel intense disgust and aversive reactions. Feelings of countertransference can interfere with therapy. Another common problem is when clients conceal their sexual preferences from their therapists. This can compromise any therapy. To avoid non-disclosure, therapists are encouraged to communicate their openness in indirect ways with literatures and artworks in the waiting room. Therapists can also deliberately bring up BDSM topics during the course of therapy. With less informed therapists, sometimes they over-focus on clients’ sexuality which detracts from original issues such as family relationships, depression, etc. A special subgroup that needs counselling is the "newbie". Individuals just coming out might have internalized shame, fear, and self-hatred about their sexual preferences. Therapists need to provide acceptance, care, and model positive attitude; providing reassurance, psychoeducation, and bibliotherapy for these clients is crucial. The average age when BDSM individuals realize their sexual preference is around 26 years. Many people hide their sexuality until they can no longer contain their desires. However, they may have married or had children by this point. Therefore, therapists need to facilitate couple's counselling and disclosure. It is important for therapists to consider fairness to partner and family of clients. In situations when boundaries between roles in the bedroom and roles in the rest of the relationship blurs, a "bleed-through" problem has occurred. Therapists need to help clients resolve distress and deal with any underlying problems that led to the initial bleed-through.

A fetish (derived from the French "fétiche"; which comes from the Portuguese "feitiço"; and this in turn from Latin "facticius", "artificial" and "facere", "to make") is an object believed to have supernatural powers, or in particular, a human-made object that has power over others. Essentially, fetishism is the emic attribution of inherent value or powers to an object.

Sexual fetishism or erotic fetishism is a sexual fixation on a nonliving object or nongenital body part. The object of interest is called the fetish; the person who has "a fetish" for that object is a fetishist. A sexual fetish may be regarded as a non-pathological aid to sexual excitement, or as a mental disorder if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life. Sexual arousal from a particular body part can be further classified as partialism.

While medical definitions restrict the term "sexual fetishism" to objects or body parts, "fetish" can also refer to sexual interest in specific activities in common discourse.

Zoophilia is a paraphilia involving a sexual fixation on non-human animals. Bestiality is cross-species sexual activity between human and non-human animals. The terms are often used interchangeably, but some researchers make a distinction between the attraction (zoophilia) and the act (bestiality).

Although sex with animals is not outlawed in some countries, in most countries, bestiality is illegal under animal abuse laws or laws dealing with buggery or crimes against nature.

Some people experience sexual excitement from the look or feel of articles made of silk or satin fabric. Such interest is usually directed towards the person wearing silk or satin, but it can also be directed towards the garment itself, or to the feel of the garment when worn.

The attraction can be to the physical properties of the garment, such as softness, smoothness, drape and shine, and to its association with elegance, glamour, romance and opulence.

The principal materials which are considered erotic are charmeuse silk (silk woven so that it has a sheen) and satins (such as acetate satin and rayon satin), but other materials with similar properties, such as spandex and polyester are also admired.

Salirophilia is a sexual fetish or paraphilia that involves deriving erotic pleasure from soiling or disheveling the object of one's desire, usually an attractive person. It may involve tearing or damaging their clothing, covering them in mud or filth, or messing their hair or makeup. The fetish does not involve harming or injuring the subject, only their appearance.

It is related to wet and messy fetishism, bukkake, omorashi, mysophilia, urolagnia and coprophilia, but extends to other areas such as forcing the partner to wear torn or poorly fitting clothing and other actions which would render them normally unattractive.

The fetish sometimes manifests itself in the defacing of statues or pictures of attractive people, especially celebrities or fictional characters. It is common to refer to the practice involving ejaculating on a photo as "facepainting". The fetishist finds this sexually exciting, rather than mere vandalism. They sometimes form collections of defaced art for future enjoyment. A video of the fetishist ejaculating on a picture of someone or a photo depicting the result is known colloquially as a "tribute".

The term comes from the French for soiling, "salir". In cases where the fetish is obsessive it is called saliromania. It is frequently confused with salophilia, an attraction to salt or salty things (especially body sweat) that derives from the Latin for salt, "sal".

Mysophilia relates to soiled or dirty material or people. Mysophiliacs may find dirt, soiled underwear, feces, or vomit to be sexually arousing.

It is possible for people with mysophilia to be aroused by unclean locales, such as an alleyway, or a dirty room/bathroom; wearing the same clothing for many days at a time; or not bathing, from mere days to several weeks.

Some people experience sexual excitement from the look or feel of a women's bra. The attraction may be to the look or feel of the material, such as lace, or how it looks on a person. Some people get excitement from removing a bra.

Diaper fetishists and diaper lovers (DLs) are often associated with adult babies, as both wear diapers, but the former do not engage in childlike behavior, while that is the distinguishing characteristic of adult babies (ABs). The majority of diaper lovers do not engage in any kind of infantile activity and are only interested in diapers. However, in certain individuals it is possible for an overlap to occur, as one can view themselves as neither exclusively an adult baby nor a diaper lover. Hence adult babies and diaper lovers collectively refer to themselves as AB/DLs. Diapers and rubber pants with "baby" prints are sold in adult sizes.

Although macrophilia literally translates to simply a "lover of large," in the context of a sexual fantasy, it is used to mean someone who is attracted to beings larger than themselves. Generally, the interest differs between people, and depends on gender and sexual orientation. They often enjoy feeling small and being abused, degraded, dominated, or eaten, and they may also view female giants as being powerful and dominating.

Commenting on why there are not as many female macrophiles, psychologist Helen Friedman theorized that because women in most societies already view men as dominant and powerful, there is no need for them to fantasize about it. Women that take on the roles of the giantess within this fetish often find the practice to be empowering and enjoy being worshipped.

The roots of macrophilia may lie in sexual arousal in childhood and early adolescence which is accidentally associated with giants, according to Dr. Mark Griffiths's speculation.

By its enthusiasts, robot fetishism is more commonly referred to by the initials "ASFR". This initialism stems from the now-defunct Usenet newsgroup "alt.sex.fetish.robots". Many devotees of this fetish refer to themselves as technosexual, or as "ASFRians". ASFR can be divided into two distinct but sometimes overlapping types of fantasies.

The first of these is simply a desire to have a ready-made android partner. This partner can be desired for sex, companionship, or any combination of the two. The main distinguishing feature of this fantasy is that the android is a completely artificial construct, often manufactured solely to fulfil the wishes of its owner. This type of fantasy or situation is referred to as "built".

The second type of fantasy prevalent within ASFR is referred to as "transformation". This involves a human who has been either willingly or unwillingly turned into an android. That person can be either oneself or one's partner, or both. It is usually the process of transformation (through whatever means it is achieved) that is the focus of this fantasy.

Many people in the ASFR community prefer either one or the other. In some cases this preference is very strong, and people can be as equally repelled by one type as they are attracted to the other. In other cases, there is as much appreciation for built as there is for transformation. A recent informal survey of ASFR community members found that two thirds prefer built while the remainder prefer transformation or some combination of both.

The aspects of this fetish that are most appreciated by members of the ASFR community are greatly varied. For some, things like robotic appearance, motion, or sound are important for arousal. For others, these are not, and a completely lifelike android that appears to be human is desired. This holds true for other aspects, such as sentience or self-awareness. The ability of the android to remove parts of its skin or other bodily appendages in order to reveal its circuitry is quite pleasing to some, but distasteful to others. There is a further divide between those who prefer an android to appear human-like and those who would prefer a more mechanical looking robot, i.e. with a metallic surface.

As realistic androids and humanoid robots do not currently exist in a form readily available to the consumer, this fetish can only be acted upon in a limited number of ways. Primarily this is done through fantasy, involving either self stimulation or sexual roleplaying with a partner. ASFR art is therefore important to aid in the reinforcement of imagination.

Art with ASFR content includes but is not limited to science fiction movies, music videos, television shows, novels, short stories, illustrations, manipulated photographs, songs and even television commercials. Such works are sought after by technosexuals since economically viable androids are not yet available. Realistic sex dolls such as the RealDoll may provide a way to explore this fetish with existing technology. Recent developments in robotics and artificial intelligence, such as those seen in the Actroid or EveR-1 may lead to the production of more advanced synthetic partners.

It is also worth noting that some ASFRians do not wish to use synthetic partners at all, and instead would prefer human partners to participate in forms of fantasy play.

In order to determine the relative prevalences of different types of fetishes, scientists obtained a sample of at least 5000 individuals worldwide from 381 Internet discussion groups. The relative prevalences were estimated based on (a) the number of groups devoted to a particular fetish, (b) the number of individuals participating in the groups and (c) the number of messages exchanged. Using these measures, feet and shoes were found to be the most common target of preferences. This is consistent with an analysis of millions of search queries by users from the USA that were accidentally released during the AOL search data scandal. Sixty-four (64) percent of the sampled population that had a preference for an object associated with the body had a preference for shoes, boots, and other footwear.

Some types of BDSM play include, but are not limited to:

- Animal roleplay

- Bondage

- Breast torture

- Cock and ball torture (CBT)

- Erotic electrostimulation

- Edgeplay

- Flogging

- Golden showers (urinating)

- Human furniture

- Japanese bondage

- Medical play

- Paraphilic infantilism

- Predicament bondage

- Pussy torture

- Sexual roleplay

- Spanking

- Suspension

- Torture

- Tickle torture

- Wax play

As a paraphilia, breast fetishism (also known as mastofact, breast partialism, or mazophilia) is a highly atypical sexual interest focused on female breasts (see partialism). The term "breast fetishism" is also used in the non-paraphilic sense, to refer to cultural attention to female breasts and the sexuality they represent, with debate existing as to whether the modern widespread fascination with breasts among heterosexual males in western societies is a sexual fetish.