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.

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).

Klismaphiles can gain satisfaction of enemas through fantasies, by actually receiving or giving one, or through the process of eliminating steps to being administered one (e.g., under the pretense of being constipated). Klismaphilia is practiced by men and women, although men are more likely to be klismaphiles, as with most paraphilias. Klismaphiles might gain pleasure from a large, water distended belly or the feeling of internal pressure. Often, klismaphiles report discovering these desires after a chance administration of an enema sometime in their childhood, but some do report discovering these feelings later on. Klismaphilia is practiced both heterosexually and homosexually. The paraphilia may be used as a substitute or as an auxiliary by its practitioners for genital sexual activity. Usually, klismaphiles carry out normal lives and successfully engage in this behavior secretly. If this is the case they will probably try to conceal the pleasure they receive from these administrations.

For administering enemas not intended for medical purposes there are specialty items, such as the aluminium nozzle shown to the right, that are commonly used in activities involving klismaphilia. Such items are available on the Internet and in sex shops in a great variety of sizes, styles, and materials.

Klismaphilia (or "klysmaphilia"), from the Greek words ("enema", from , "deluge, flood") and ("(fraternal) love"), is a paraphilia involving enjoyment of, and sexual arousal from, enemas.