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 frotteurism is unknown. The DSM estimates that 10%–14% of men seen in clinical settings for paraphilias or hypersexuality have frotteuristic disorder, indicating that the population prevalence is lower. However, frotteuristic acts, as opposed to frotteuristic disorder, may occur in up to 30% of men in the general population. The majority of frotteurs are male and the majority of victims are female, although female on male, female on female, and male on male frotteurs exist. This activity is often done in circumstances where the victim cannot easily respond, in a public place such as a crowded train or concert.

Usually, such nonconsensual sexual contact is viewed as a criminal offense: a form of sexual assault albeit often classified as a misdemeanor with minor legal penalties. Conviction may result in a sentence or psychiatric treatment.

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).

Frotteurism is a paraphilic interest in rubbing, usually one's pelvic area or erect penis, against a non-consenting person for sexual pleasure. It may involve touching any part of the body, including the genital area. A person who practices frotteuristic acts is known as a "frotteur". Toucherism is sexual arousal based on grabbing or rubbing one's hands against an unexpecting (and non-consenting) person. It usually involves touching breasts, buttocks or genital areas, often while quickly walking across the victim's path. Some psychologists consider toucherism a manifestation of frotteurism, while others distinguish the two. In clinical medicine, treatment of frotteuristic disorder involves cognitive behavior therapy coupled with the administration of a SSRI.

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.

Courtship disorder is a theoretical construct in sexology in which a certain set of paraphilias are seen as specific instances of anomalous courtship instincts in men. The specific paraphilias are biastophilia (paraphilic rape), exhibitionism, frotteurism, telephone scatologia, and voyeurism. According to the "courtship disorder hypothesis", there is a species-typical courtship process in human males consisting of four phases, and anomalies in different phases result in one of these paraphilic sexual interests. That is, instead of being independent paraphilias, this theory sees these sexual interests as individual symptoms of a single underlying disorder.

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.

According to the "courtship disorder hypothesis", there is a species-typical courtship process in humans consisting of four phases. These phases are: "(1) looking for and appraising potential sexual partners; (2) pretactile interaction with those partners, such as by smiling at and talking to them; (3) tactile interaction with them, such as by embracing or petting; (4) and then sexual intercourse."

The associations between these phases and these paraphilias were first outlined by Kurt Freund, the originator of the theory: A disturbance of the search phase of courtship manifests as voyeurism, a disturbance of the pretactile interaction phase manifests as exhibitionism or telephone scatologia, a disturbance of the tactile interaction phase manifests as toucheurism or frotteurism, and the absence of the courtship behavior phases manifests as paraphilic rape (i.e., biastophilia). According to Freund, these paraphilias "can be conceptualized as a preference for a pattern of behavior or erotic fantasy in which one of these four phases of sexual interaction is intensified and distorted to such an extent that it appears to be a caricature of the normal, while the remaining phases are either omitted entirely or are retained only in a vestigial way."

Freund noted that "troilism" (a paraphilia for observing one’s sexual/romantic partner sexually interacting with a third party, usually unbeknownst to the third party) might also be a courtship disorder, troilism being a variant of voyeurism.

Appropriate behaviors depend on the social and cultural context, including time and place. Some behaviors that are unacceptable under most circumstances, such as public nudity or sexual contact between dancers, may be accepted or even encouraged during celebrations like Carnival or Mardi Gras. Where such cultural festivals alter normative courtship behaviors, the signs of courtship disorder may be masked or altered.