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.

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.

There are many ways a person may go about receiving therapy for ego-dystonic sexual orientation associated with homosexuality. There is no known therapy for other types of ego-dystonic sexual orientations. Therapy can be aimed at changing sexual orientation, sexual behaviour, or helping a client become more comfortable with their sexual orientation and behaviours. Human rights groups have accused some countries of performing these treatments on egosyntonic homosexuals. One survey suggested that viewing the same-sex activities as compulsive facilitated commitment to a mixed-orientation marriage and to monogamy. Treatment may include sexual orientation change efforts or treatment to alleviate the stress. In addition, some people seek non-professional methods, such as religious counselling or attendance in an ex-gay group.

Therapeutic approaches for GIDC differ from those used on adults and have included behavior therapy, psychodynamic therapy, group therapy, and parent counseling. Proponents of this intervention seek to reduce gender dysphoria, make children more comfortable with their bodies, lessen ostracism, and reduce the child's psychiatric comorbidity. The majority of therapists currently employ these techniques. "Two short term goals have been discussed in the literature: the reduction or elimination of social ostracism and conflict, and the alleviation of underlying or associated psychopathology. Longer term goals have focused on the prevention of transsexualism and/or homosexuality."

Individual therapy with the child seeks to identify and resolve underlying factors, including familial factors; encourage identification by sex assigned at birth; and encourage same-sex friendships. Parent counseling involves setting limits on the child's cross-gender behavior; encouraging gender-neutral or sex-typical activities; examining familial factors; and examining parental factors such as psychopathology. Longtime researchers of gender identity disorder, Kenneth Zucker and Susan Bradley, state that it has been found that boys with gender identity disorder often have mothers who to an extent reinforced behavior more stereotypical of young girls. They also note that children with gender identity disorder tend to come from families where cross-gender role behavior was not explicitly discouraged. However, they also acknowledge that one could view these findings as merely indicative of the fact that parents who were more accepting of their child's cross-gender role behavior are also more likely to bring their children to a clinical psychiatrist as opposed to parents who are less accepting of cross-gender role behavior in their children (Bradley, Zucker, 1997). " Proponents acknowledge limited data on GIDC: "apart from a series of intrasubject behaviour therapy case reports from the 1970s, one will find not a single randomized controlled treatment trial in the literature" (Zucker 2001). Psychiatrist Domenico Di Ceglie opines that for therapeutic intervention, "efficacy is unclear," and psychologist Bernadette Wren says, "There is little evidence, however, that any psychological treatments have much effect in changing gender identity although some treatment centres continue to promote this as an aim (e.g. Zucker, & Bradley, 1995)." Zucker has stated that "the therapist must rely on the 'clinical wisdom' that has accumulated and to utilize largely untested case formulation conceptual models to inform treatment approaches and decisions."

"Sex reassignment therapy" (SRT) is an umbrella term for all medical treatments related to sex reassignment of both transgender and intersex people.

Individuals make different choices regarding sex reassignment therapy, which may include female-to-male or male-to-female hormone replacement therapy (HRT) to modify secondary sex characteristics, sex reassignment surgery (such as orchiectomy) to alter primary sex characteristics, chest surgery such as top surgery or breast augmentation, or, in the case of trans women, a trachea shave, facial feminization surgery or permanent hair removal.

To obtain sex reassignment therapy, transsexual people are generally required to undergo a psychological evaluation and receive a diagnosis of gender identity disorder in accordance with the Standards of Care (SOC) as published by the World Professional Association for Transgender Health. This assessment is usually accompanied by counseling on issues of adjustment to the desired gender role, effects and risks of medical treatments, and sometimes also by psychological therapy. The SOC are intended as guidelines, not inflexible rules, and are intended to ensure that clients are properly informed and in sound psychological health, and to discourage people from transitioning based on unrealistic expectations.

The APA has roundly dismissed so-called conversion therapy (sometimes called "ex-gay" therapy) as unproductive and potentially harmful.

One version of conversion therapy, Gender Wholeness Therapy was designed by an ex-gay Licensed Professional Counselor, David Matheson. "The emphasis in Mr. Matheson's counselling is on helping men — all his clients are male — develop 'gender wholeness' by addressing emotional issues and building healthy connections with other men. He says he believes that helps reduce homosexual desires.

Another variation of conversion therapy, "gender-affirmative therapy" has been described by A. Dean Byrd as follows: "The basic premise of gender-affirmative therapy is that social and emotional variables affect gender identity which, in turn, determines sexual orientation. The work of the therapist is to help people understand their gender development. Subsequently, such individuals are able to make choices that are consistent with their value system. The focus of therapy is to help clients fully develop their masculine or feminine identity".

Several organizations have started retreats led by coaches aimed at helping participants diminish same-sex desires. These retreats tend to use a variety of techniques. Journey into Manhood, put on by People Can Change, uses "a wide variety of large-group, small-group and individual exercises, from journaling to visualizations (or guided imagery) to group sharing and intensive emotional-release work." Weekends put on by Adventure in Manhood support "healthy bonding with men, through masculine activity, teamwork, and socialization." Though not specific to gay men, several gay men attended the New Warrior Training Adventure, a weekend put on by ManKind Project, which is a "process of initiation and self-examination that is designed to catalyse the development of a healthy and mature masculine self." Joe Dallas, a prominent ex-gay, leads a monthly five-day men's retreat on sexual purity titled, Every Man's Battle.

Several reparative therapies have been established, including:

- Sexual identity therapy was designed by Warren Throckmorton and Mark Yarhouse, and was endorsed by Robert L. Spitzer, prior to Spitzer's backing away from this belief that he had proven reparative therapy at times successful. Its purpose is to help patients line up their sexual identity with their beliefs and values. Therapy involves four phases: (1) assessment, (2) advanced or expanded informed consent, (3) psychotherapy, and (4) social integration of a valued sexual identity.

- Group psychotherapy uses group sessions led by a single psychologist and focuses on conflict surrounding homosexual expression.

- Context Specific Therapy was designed by Jeffrey Robinson. It does not work with any one theory of homosexuality, but uses several theoretical backgrounds according to the client's need, and is based on phenomenological research. It does not seek to change the client's orientation, but instead focuses on diminishing homosexual thoughts and behaviours. It works within the client's own view of God, noting that "individuals who are successful at overcoming homosexual problems are motivated by strong religious values".

- MAP Therapy is designed for both the individual with ego-dystonic sexual orientation and their family members. There are four main paths that clients may choose to take: (1) they can affirm an LGB identity, (2) they can foster a lifestyle of celibacy, (3) they can work on developing heterosexual attractions, or (4) they can explore their options.

Transvestism is the practice of dressing and acting in a style or manner traditionally associated with the opposite sex. In some cultures, transvestism is practiced for religious, traditional or ceremonial reasons.

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.

Biphobia is aversion toward bisexuality and toward bisexual people as a social group or as individuals. It can take the form of denial that bisexuality is a genuine sexual orientation, or of negative stereotypes about people who are bisexual (such as the beliefs that they are promiscuous or dishonest). People of any sexual orientation can experience or perpetuate biphobia, and it is a source of social discrimination against bisexual people.

A non-operative transsexual person, or non-op, is someone who has not had SRS, and does not intend to have it in the future. There can be various reasons for this, from the personal to the financial.

The following are some of the partialisms commonly found among people:

BDSM is a variety of often erotic practices or roleplaying involving bondage, discipline, dominance and submission, sadomasochism, and other related interpersonal dynamics. Given the wide range of practices, some of which may be engaged in by people who do not consider themselves as practicing BDSM, inclusion in the BDSM community or subculture is usually dependent upon self-identification and shared experience.

The term "BDSM" is first recorded in a Usenet posting from 1991, and is interpreted as a combination of the abbreviations B/D (Bondage and Discipline), D/s (Dominance and submission), and S/M (Sadism and Masochism). BDSM is now used as a catch-all phrase covering a wide range of activities, forms of interpersonal relationships, and distinct subcultures. BDSM communities generally welcome anyone with a non-normative streak who identifies with the community; this may include cross-dressers, body modification enthusiasts, animal roleplayers, rubber fetishists, and others.

Activities and relationships within a BDSM context are often characterized by the participants taking on complementary, but unequal roles; thus, the idea of informed consent of both the partners is essential. The terms "submissive" and "dominant" are often used to distinguish these roles: the dominant partner ("dom") takes psychological control over the submissive ("sub"). The terms "top" and "bottom" are also used: the top is the instigator of an action while the bottom is the receiver of the action. The two sets of terms are subtly different: for example, someone may choose to act as bottom to another person, for example, by being whipped, purely recreationally, without any implication of being psychologically dominated by them, or a submissive may be ordered to massage their dominant partner. Despite the bottom performing the action and the top receiving they have not necessarily switched roles.

The abbreviations "sub" and "dom" are frequently used instead of "submissive" and "dominant". Sometimes the female-specific terms "mistress", "domme" or "dominatrix" are used to describe a dominant woman, instead of the gender-neutral term "dom". Individuals who can change between top/dominant and bottom/submissive roles—whether from relationship to relationship or within a given relationship—are known as "switches". The precise definition of roles and self-identification is a common subject of debate within the community.

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.

Transmisogyny (sometimes trans-misogyny) is the intersection of transphobia and misogyny. Transphobia is defined as "the irrational fear of, aversion to, or discrimination against transgender or transsexual people". Misogyny is defined as "a hatred of women". Therefore, transmisogyny includes negative attitudes, hate, and discrimination of transgender or transsexual individuals who fall on the feminine side of the gender spectrum, particularly transgender women. The term was coined by Julia Serano in her 2007 book "Whipping Girl" and used to describe the unique discrimination faced by trans women because of "the assumption that femaleness and femininity are inferior to, and exist primarily for the benefit of, maleness and masculinity", and the way that transphobia intensifies the misogyny faced by trans women (and vice versa). It is said many trans women experience an additional layer of misogyny in the form of fetishization; Serano talks about how society views trans women in certain ways that sexualize them, such as them transitioning for sexual reasons, or ways where they’re seen as sexually promiscuous.Transmisogyny is a central concept in transfeminism and is commonly referenced in intersectional feminist theory. That trans women's femaleness (rather than only their femininity) is a source of transmisogyny is denied by certain radical feminists, who claim that trans women are not female.

Lesbophobia (sometimes lesbiphobia) comprises various forms of negativity towards lesbians as individuals, as couples, or as a social group. Based on the categories of sex, sexual orientation, lesbian identity, and gender expression, this negativity encompasses prejudice, discrimination, and abuse, in addition to attitudes and feelings ranging from disdain to hostility. As such, lesbophobia is sexism against women that intersects with homophobia and vice versa.

Though coined as late as the 1910s, the phenomenon is not new. It was referred to in the Hebrew Bible. The word has undergone several changes of meaning since it was first coined and is still used in a variety of senses. Today, the term "transvestite" is commonly considered outdated and derogatory, with the term "cross-dresser" used as a more appropriate replacement. This is because the term "transvestite" was historically used to diagnose medical disorders, including mental health disorders, and transvestism was viewed as a disorder, but the term "cross-dresser" was coined by the transgender community. In some cases, however, the term "transvestite" is seen as more appropriate for use by members of the transgender community instead of by those outside of the transgender community, and some have reclaimed the word.

In May 2013, the American Psychiatric Association published the DSM-5 in which the GIDC diagnosis was removed and replaced with gender dysphoria, for the first time in its own distinct chapter. Lev states that gender dysphoria places the focus on distress with one's body rather than conformity with societal gender norms, and that this change was accompanied by changes to sexist language and a reduced reliance on binary gender categories. Gender dysphoria reframes the diagnosis as a time-limited distress of the body which is potentially rectified with access to gender transition procedures, rather than a lifetime disorder of the identity.

Partialism is sexual interest with an exclusive focus on a specific part of the body other than the genitals. Partialism is categorized as a fetishistic disorder in the DSM-5 of the American Psychiatric Association only if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life. In the DSM-IV, it was considered a separate paraphilia (not otherwise specified), but was merged into fetishistic disorder by the DSM-5. Individuals who exhibit partialism sometimes describe the anatomy of interest to them as having equal or greater erotic attraction for them as do the genitals.

Partialism occurs in heterosexual, bisexual, and homosexual individuals. The foot is considered one of the most common partialisms.

Males with late onset gender dysphoria "frequently" display transvestic fetishism.

Some male transvestic fetishists collect women's clothing, e.g. panties, nightgowns, babydolls, bridal gowns, slips, brassieres, and other types of nightwear, lingerie, stockings, pantyhose, shoes, and boots, items of a distinct feminine look and feel. They may dress in these feminine garments and take photographs of themselves while living out their fantasies.

According to DSM-IV, this fetishism was limited to heterosexual men; however, DSM-5 does not have this restriction, and opens it to women and men with this interest, regardless of their sexual orientation.

There are two key criteria before a psychiatric diagnosis of "transvestic fetishism" is made:

1. Individuals must be sexually aroused by the act of cross-dressing.

2. Individuals must experience significant distress or impairment – socially or occupationally – because of their behavior.

Transvestic fetishism is a psychiatric diagnosis applied to those who are thought to have an excessive sexual or erotic interest in cross-dressing; this interest is often expressed in autoerotic behavior. It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal, and is categorized as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association. (Sexual arousal in response to donning sex-typical clothing is homeovestism.)

Sexophobia in clinical talk has an effect on the way patients speak to their doctors, as it manifests itself in the communication strategies that are employed to speak about private health problems. In that sense, the use of neutral and veiled vocabulary by doctors can discourage patients to speak openly about their sexual issues.

Otherwise, historian and sociologist Cindy Patton has identified sexophobia as one of the main trends that characterised the development of the second phase of the VIH epidemics in Great Britain, along with homophobia and germophobia.

Transphobia is a range of negative attitudes, feelings or actions toward transgender or transsexual people, or toward transsexuality. Transphobia can be emotional disgust, fear, violence, anger or discomfort felt or expressed towards people who do not conform to society's gender expectations. It is often expressed alongside homophobic views and hence is often considered an aspect of homophobia. Transphobia is a type of prejudice and discrimination similar to racism and sexism, and transgender people of color are often subjected to all three forms of discrimination at once.

Child victims of transphobia experience harassment, school bullying, and violence in school, foster care, and social programs. Adult victims experience public ridicule, harassment including misgendering, taunts, threats of violence, robbery, and false arrest; many feel unsafe in public. A high percentage report being victims of sexual violence. Some are refused healthcare or suffer workplace discrimination, including being fired for being transgender, or feel under siege by conservative political or religious groups who oppose laws to protect them. There is even discrimination from some people within the movement for the rights of gender and sexual minorities.

Besides the increased risk of violence and other threats, the stress created by transphobia can cause negative emotional consequences which may lead to substance abuse, running away from home (in minors), and a higher rate of suicide.

In the Western world, there have been gradual changes towards the establishment of policies of non-discrimination and equal opportunity. The trend is also taking shape in developing nations. In addition, campaigns regarding the LGBT community are being spread around the world to improve acceptance; the "Stop the Stigma" campaign by the UN is one such development.

Surgery is sometimes performed to alter the appearance of the genitals. However many surgeries performed on intersex people lack clear evidence of necessity, can be considered as mutilating, and are widely considered to be human rights violations when performed without the informed consent of the recipient.

Homophobic attitudes and behaviors may be linked to sexophobia: doctor Martin Kantor describes many homophobes as being basically sexophobes, who fear and loathe sexual relationships both between partners of the same sex and between heterosexual partners.

Homophobia encompasses a range of negative attitudes and feelings toward homosexuality or people who are identified or perceived as being lesbian, gay, bisexual or transgender (LGBT). It has been defined as contempt, prejudice, aversion, hatred or antipathy, may be based on irrational fear, and is often related to religious beliefs.

Homophobia is observable in critical and hostile behavior such as discrimination and violence on the basis of sexual orientations that are non-heterosexual. Recognized types of homophobia include "institutionalized" homophobia, e.g. religious homophobia and state-sponsored homophobia, and "internalized" homophobia, experienced by people who have same-sex attractions, regardless of how they identify.

Negative attitudes toward identifiable LGBT groups have similar yet specific names: lesbophobia is the intersection of homophobia and sexism directed against lesbians, biphobia targets bisexuality and bisexual people, and transphobia targets transgender and transsexual people and gender variance or gender role nonconformity. According to 2010 Hate Crimes Statistics released by the FBI National Press Office, 19.3 percent of hate crimes across the United States "were motivated by a sexual orientation bias." Moreover, in a Southern Poverty Law Center 2010 "Intelligence Report" extrapolating data from fourteen years (1995–2008), which had complete data available at the time, of the FBI's national hate crime statistics found that LGBT people were "far more likely than any other minority group in the United States to be victimized by violent hate crime."

The term "homophobia" and its usage have been criticized by several sources as unwarrantedly pejorative