Research has shown that paraphilias are rarely observed in women. However, there have been some studies on females with paraphilias. Sexual masochism has been found to be the most commonly observed paraphilia in women, with approximately 1 in 20 cases of sexual masochism being female.

Many acknowledge the scarcity of research on female paraphilias. The majority of paraphilia studies are conducted on people who have been convicted of sex crimes. Since the number of male convicted sex offenders far exceeds the number of female convicted sex offenders, research on paraphilic behavior in women is consequently lacking. Some researchers argue that an underrepresentation exists concerning pedophilia in females. Due to the low number of women in studies on pedophilia, most studies are based from "exclusively male samples". This likely underrepresentation may also be attributable to a "societal tendency to dismiss the negative impact of sexual relationships between young boys and adult women". Michele Elliott has done extensive research on child sexual abuse committed by females, publishing the book "Female Sexual Abuse of Children: The Last Taboo" in an attempt to challenge the gender-biased discourse surrounding sex crimes. John Hunsley states that physiological limitations in the study of female sexuality must also be acknowledged when considering research on paraphilias. He states that while a man's sexual arousal can be directly measured from his erection (see penile plethysmograph), a woman's sexual arousal cannot be measured as clearly (see vaginal photoplethysmograph), and therefore research concerning female sexuality is rarely as conclusive as research on men.

The prevalence of pedophilia in the general population is not known, but is estimated to be lower than 5% among adult men. Less is known about the prevalence of pedophilia in women, but there are case reports of women with strong sexual fantasies and urges towards children. Most sexual offenders against children are male. Females may account for 0.4% to 4% of convicted sexual offenders, and one study estimates a 10 to 1 ratio of male-to-female child molesters. The true number of female child molesters may be underrepresented by available estimates, for reasons including a "societal tendency to dismiss the negative impact of sexual relationships between young boys and adult women, as well as women's greater access to very young children who cannot report their abuse", among other explanations.

The term "pedophile" is commonly used by the public to describe all child sexual abuse offenders. This usage is considered problematic by researchers, because many child molesters do not have a strong sexual interest in prepubescent children, and are consequently not pedophiles. There are motives for child sexual abuse that are unrelated to pedophilia, such as stress, marital problems, the unavailability of an adult partner, general anti-social tendencies, high sex drive, or alcohol use. As child sexual abuse is not automatically an indicator that its perpetrator is a pedophile, offenders can be separated into two types: pedophilic and non-pedophilic (or preferential and situational). Estimates for the rate of pedophilia in detected child molesters generally range between 25% and 50%. A 2006 study found that 35% of its sample of child molesters were pedophilic. Pedophilia appears to be less common in incest offenders, especially fathers and step-fathers. According to a U.S. study on 2429 adult male sex offenders who were categorized as "pedophiles", only 7% identified themselves as exclusive; indicating that many or most child sexual abusers may fall into the non-exclusive category.

Some pedophiles do not molest children. Little is known about this population because most studies of pedophilia use criminal or clinical samples, which may not be representative of pedophiles in general. Researcher Michael Seto suggests that pedophiles who commit child sexual abuse do so because of other anti-social traits in addition to their sexual attraction. He states that pedophiles who are "reflective, sensitive to the feelings of others, averse to risk, abstain from alcohol or drug use, and endorse attitudes and beliefs supportive of norms and the laws" may be unlikely to abuse children. A 2015 study indicates that pedophiles who molested children are neurologically distinct from non-offending pedophiles. The pedophilic molesters had neurological deficits suggestive of disruptions in inhibitory regions of the brain, while non-offending pedophiles had no such deficits.

According to Abel, Mittleman, and Becker (1985) and Ward "et al." (1995), there are generally large distinctions between the characteristics of pedophilic and non-pedophilic molesters. They state that non-pedophilic offenders tend to offend at times of stress; have a later onset of offending; and have fewer, often familial, victims, while pedophilic offenders often start offending at an early age; often have a larger number of victims who are frequently extrafamilial; are more inwardly driven to offend; and have values or beliefs that strongly support an offense lifestyle. One study found that pedophilic molesters had a median of 1.3 victims for those with girl victims and 4.4 for those with boy victims. Child molesters, pedophilic or not, employ a variety of methods to gain sexual access to children. Some groom their victims into compliance with attention and gifts, while others use threats, alcohol or drugs, or physical force.

Although what causes pedophilia is not yet known, researchers began reporting a series of findings linking pedophilia with brain structure and function, beginning in 2002. Testing individuals from a variety of referral sources inside and outside the criminal justice system as well as controls, these studies found associations between pedophilia and lower IQs, poorer scores on memory tests, greater rates of non-right-handedness, greater rates of school grade failure over and above the IQ differences, lesser physical height, greater probability of having suffered childhood head injuries resulting in unconsciousness, and several differences in MRI-detected brain structures. They report that their findings suggest that there are one or more neurological characteristics present at birth that cause or increase the likelihood of being pedophilic. Some studies have found that pedophiles are less cognitively impaired than non-pedophilic child molesters. A 2011 study reported that pedophilic child molesters had deficits in response inhibition, but no deficits in memory or cognitive flexibility. Evidence of familial transmittability "suggests, but does not prove that genetic factors are responsible" for the development of pedophilia. A 2015 study indicated that pedophilic offenders have a normal IQ.

Another study, using structural MRI, indicated that male pedophiles have a lower volume of white matter than a control group. Functional magnetic resonance imaging (fMRI) has indicated that child molesters diagnosed with pedophilia have reduced activation of the hypothalamus as compared with non-pedophilic persons when viewing sexually arousing pictures of adults. A 2008 functional neuroimaging study notes that central processing of sexual stimuli in heterosexual "paedophile forensic inpatients" may be altered by a disturbance in the prefrontal networks, which "may be associated with stimulus-controlled behaviours, such as sexual compulsive behaviours". The findings may also suggest "a dysfunction at the cognitive stage of sexual arousal processing".

Blanchard, Cantor, and Robichaud (2006) reviewed the research that attempted to identify hormonal aspects of pedophiles. They concluded that there is some evidence that pedophilic men have less testosterone than controls, but that the research is of poor quality and that it is difficult to draw any firm conclusion from it.

While not causes of pedophilia themselves, childhood abuse by adults or comorbid psychiatric illnesses—such as personality disorders and substance abuse—are risk factors for acting on pedophilic urges. Blanchard, Cantor, and Robichaud addressed comorbid psychiatric illnesses that, "The theoretical implications are not so clear. Do particular genes or noxious factors in the prenatal environment predispose a male to develop both affective disorders and pedophilia, or do the frustration, danger, and isolation engendered by unacceptable sexual desires—or their occasional furtive satisfaction—lead to anxiety and despair?" They indicated that, because they previously found mothers of pedophiles to be more likely to have undergone psychiatric treatment, the genetic possibility is more likely.

A study analyzing the sexual fantasies of 200 heterosexual men by using the Wilson Sex Fantasy Questionnaire exam determined that males with a pronounced degree of paraphilic interest (including pedophilia) had a greater number of older brothers, a high 2D:4D digit ratio (which would indicate low prenatal androgen exposure), and an elevated probability of being left-handed, suggesting that disturbed hemispheric brain lateralization may play a role in deviant attractions.

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

Ego-dystonic sexual orientation is an ego-dystonic mental disorder characterized by having a sexual orientation or an attraction that is at odds with one's idealized self-image, causing anxiety and a desire to change one's orientation or become more comfortable with one's sexual orientation. It describes not innate sexual orientation itself, but a conflict between the sexual orientation one wishes to have and the sexual orientation one actually possesses.

GID exists when a person suffers discontent due to gender identity, causing them emotional distress. Researchers disagree about the nature of distress and impairment in people with GID. Some authors have suggested that people with GID suffer because they are stigmatized and victimized; and that, if society had less strict gender divisions, transsexual people would suffer less.

A twin study (based on seven people in a 314 sample) suggested that GID may be 62% heritable, indicating the possibility of a genetic influence or prenatal development as its origin, in these cases.

In the United States, following a series of landmark cases in the Supreme Court of the United States, persons diagnosed with paraphilias, particularly pedophilia ("Kansas v. Hendricks", 1997) and exhibitionism ("Kansas v. Crane", 2002), with a history of anti-social behavior and related criminal history, can be held indefinitely in civil confinement under various state legislation generically known as sexually violent predator laws and the federal Adam Walsh Act ("United States v. Comstock", 2010).

Symptoms of GD in children may include any of the following: disgust at their own genitalia, social isolation from their peers, anxiety, loneliness and depression. According to the American Psychological Association, transgender children are more likely to experience harassment and violence in school, foster care, residential treatment centers, homeless centers and juvenile justice programs than other children.

Adults with GD are at increased risk for stress, isolation, anxiety, depression, poor self-esteem and suicide. Studies indicate that transgender people have an extremely high rate of suicide attempts; one study of 6,450 transgender people in the United States found 41% had attempted suicide, compared to a national average of 1.6%. It was also found that suicide attempts were less common among transgender people who said their family ties had remained strong after they came out, but even transgender people at comparatively low risk were still much more likely to have attempted suicide than the general population. Transgender people are also at heightened risk for certain mental disorders such as eating disorders.

Sadomasochism is the giving or receiving pleasure from acts involving the receipt or infliction of pain or humiliation. Practitioners of sadomasochism may seek sexual gratification from their acts. While the terms sadist and masochist refer respectively to one who enjoys giving or receiving pain, practitioners of sadomasochism may switch between activity and passivity.

The abbreviation S&M is often used for sadomasochism, although practitioners themselves normally remove the ampersand and use the acronym S-M or SM or S/M when written throughout the literature. Sadomasochism is not considered a clinical paraphilia unless such practices lead to clinically significant distress or impairment for a diagnosis. Similarly, sexual sadism within the context of mutual consent, generally known under the heading BDSM, is distinguished from non-consensual acts of sexual violence or aggression.

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.

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.

Gender identity is a concept, specifically psychological, that refers to one's sense of being a male or female in regards to sexual orientation. Individuals who are diagnosed with gender identity disorder are classified as being dissatisfied with their anatomically determined gender.

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.

Psychosexual disorder is a term which may simply refer to a sexual problem that is psychological, rather than physiological in origin. "Psychosexual disorder" was a term used in . The term of psychosexual disorder (Turkish: "Psikoseksüel bozukluk") used by the TAF for homosexuality as a reason to ban the LGBT people from military service.

Low sexual desire alone is not equivalent to HSDD because of the requirement in HSDD that the low sexual desire causes marked distress and interpersonal difficulty and because of the requirement that the low desire is not better accounted for by another disorder in the DSM or by a general medical problem. It is therefore difficult to say exactly what causes HSDD. It is easier to describe, instead, some of the causes of low sexual desire.

In men, though there are theoretically more types of HSDD/low sexual desire, typically men are only diagnosed with one of three subtypes.

- Lifelong/generalised: The man has little or no desire for sexual stimulation (with a partner or alone) and never had.

- Acquired/generalised: The man previously had sexual interest in his present partner, but lacks interest in sexual activity, partnered or solitary.

- Acquired/situational: The man was previously sexually interested in his present partner but now lacks sexual interest in this partner but has desire for sexual stimulation (i.e. alone or with someone other than his present partner.)

Though it can sometimes be difficult to distinguish between these types, they do not necessarily have the same cause. The cause of lifelong/generalized HSDD is unknown. In the case of acquired/generalized low sexual desire, possible causes include various medical/health problems, psychiatric problems, low levels of testosterone or high levels of prolactin. One theory suggests that sexual desire is controlled by a balance between inhibitory and excitatory factors. This is thought to be expressed via neurotransmitters in selective brain areas. A decrease in sexual desire may therefore be due to an imbalance between neurotransmitters with excitatory activity like dopamine and norepinephrine and neurotransmitters with inhibitory activity, like serotonin. The, New York-based, "New View Campaign" organization has expressed skepticism about too much emphasis on explanations based on neurotransmitters because emphasis on such explanations have been made largely by "educational" efforts funded by Boehringer-Ingelheim while it was attempting to get the FDA to approve a drug affecting neurotransmitters for treatment for HSDD. Low sexual desire can also be a side effect of various medications. In the case of acquired/situational HSDD, possible causes include intimacy difficulty, relationship problems, sexual addiction, and chronic illness of the man’s partner. The evidence for these is somewhat in question. Some claimed causes of low sexual desire are based on empirical evidence. However, some are based merely on clinical observation. In many cases, the cause of HSDD is simply unknown.

There are some factors that are believed to be possible causes of HSDD in women. As with men, various medical problems, psychiatric problems (such as mood disorders), or increased amounts of prolactin can cause HSDD. Other hormones are believed to be involved as well. Additionally, factors such as relationship problems or stress are believed to be possible causes of reduced sexual desire in women. According to one recent study examining the affective responses and attentional capture of sexual stimuli in women with and without HSDD, women with HSDD do not appear to have a negative association to sexual stimuli, but rather a weaker positive association than women without HSDD

In 2009 Amy Marsh, a clinical sexologist, surveyed the twenty-one English-speaking members of Erika Eiffel's 40-strong OS Internationale about their experiences. About half reported autism spectrum disorders: six had been diagnosed, four were affected but not diagnosed, and three of the remaining nine reported having "some traits." According to Marsh, "The emotions and experiences reported by OS people correspond to general definitions of sexual orientation," such as that in an APA article "on sexual orientation and homosexuality ... [which] refers to sexual orientation as involving 'feelings and self concept.'"

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.

Object sexuality or objectophilia is a form of sexuality focused on particular inanimate objects. Those individuals with this expressed preference may feel strong feelings of attraction, love, and commitment to certain items or structures of their fixation. For some, sexual or even close emotional relationships with humans are incomprehensible. Some object-sexual individuals also often believe in animism, and sense reciprocation based on the belief that objects have souls, intelligence, and feelings, and are able to communicate.

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.

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.

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.

Hypoactive sexual desire disorder (HSDD) or inhibited sexual desire (ISD) is considered a sexual dysfunction and is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug (legal or illegal), some other medical condition, or asexuality. A person with ISD will not start, or respond to their partner's desire for, sexual activity.

There are various subtypes. HSDD can be general (general lack of sexual desire) or situational (still has sexual desire, but lacks sexual desire for current partner), and it can be acquired (HSDD started after a period of normal sexual functioning) or lifelong (the person has always had no/low sexual desire.)

HSDD has garnered much criticism, primarily by asexual activists. They point out that HSDD puts asexuality in the same position homosexuality was from 1974-1987. The DSM at that time recognised 'ego-dystonic homosexuality' as a disorder, defined as sexual interest in the same sex that caused significant distress. The DSM itself officially recognized this as unnecessarily pathologizing homosexuality and removed it as a disorder in 1987.

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.

Sexual maturation disorder is a disorder of anxiety or depression related to an uncertainty about one's gender identity or sexual orientation. The World Health Organization (WHO) lists sexual maturation disorder in the ICD-10, under "Psychological and behavioural disorders associated with sexual development and orientation".

Sexual orientation, by itself, is not a disorder and is not classified under this heading. It differs from ego-dystonic sexual orientation where the sexual orientation or gender identity is repressed or denied.

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.