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).

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.

Sexual sadism disorder is the condition of experiencing sexual arousal in response to the extreme pain, suffering or humiliation of others. Several other terms have been used to describe the condition, and the condition may overlap with other conditions that involve inflicting pain. It is distinct from situations in which consenting individuals use mild or simulated pain or humiliation for sexual excitement. The words "sadism" and "" are derived from Marquis de Sade.

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

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.

With paraphilic coercive disorder, the individual employs enough force to subdue a victim, but with sexual sadism disorder, the individual often continues to inflict harm regardless of the compliance of the victim, which sometimes escalates not only to the death of the victim, but also to the mutilation of the body. What is experienced by the sadist as sexual does not always appear obviously sexual to non-sadists: Sadistic rapes do not necessarily include penile penetration of the victim. In a survey of offenses, 77% of cases included sexual bondage, 73% included anal rape, 60% included blunt force trauma, 57% included vaginal rape, and 40% included penetration of the victim by a foreign object. Moreover, in 40% of cases, the offender kept a personal item of the victim as a souvenir.

On personality testing, sadistic rapists apprehended by law enforcement have shown elevated traits of impulsivity, hypersexuality, callousness, and psychopathy.

Although there appears to be a continuum of severity from mild ("hyperdominance" or "BDSM") to moderate ("paraphilic coercive disorder") to severe ('sexual sadism disorder), it is not clear if they are genuinely related or only appear related superficially.

Very little is known about how sexual sadism disorder develops. Most of the people diagnosed with sexual sadism disorder come to the attention of authorities by committing sexually motivated crimes. Surveys have also been conducted including people who are interested in only mild and consensual forms of sexual pain/humiliation (BDSM).

Most of the people with full-blown sexual sadism disorder are male, whereas the sex ratio of people interested in BDSM is closer to 2:1 male-to-female.

People with sexual sadism disorder" are at an elevated likelihood of having other paraphilic sexual interests.

Gerontophilia is the sexual preference for the elderly. A person with such a sexual preference is a gerontophile. The word "gerontophilia" was coined in 1901 by Richard von Krafft-Ebing. It derives from Greek: geron, meaning "old man or woman" and philie, meaning "love". Gerontophilia is classified as a paraphilia, but is not mentioned in the "Diagnostic and Statistical Manual of Mental Disorders" or International Classification of Diseases.

The prevalence of gerontophilia is unknown. A study of pornographic search terms on a peer-to-peer network reported that 0.15% had gerontophilic themes. Sex offenders with elderly victims do not necessarily have gerontophilia. There are other possible motivations for these offenses, such as rage or sadism, or the increased vulnerability of elderly as a social group, which are factors that may not involve a sexual preference for the elderly. There are no studies showing that most such offenders are gerontophiles. In one small study, two of six sex offenders against the elderly evinced gerontophilic tendencies. Gerontophilia can also be expressed with consenting elderly partners in a legal context.

Research on gerontophilia is limited to a small number of case studies, beginning with a paper by French physician Charles Féré in 1905. Féré described a 27-year-old man who rejected an arranged marriage with a 20-year-old "beauty" in favor of a 62-year-old woman. Such studies commonly report that the subject had an early sexual experience with a much older woman.

The prognosis for psychopathy in forensic and clinical settings is quite poor, with some studies reporting that treatment may worsen the antisocial aspects of psychopathy as measured by recidivism rates, though it is noted that one of the frequently cited studies finding increased criminal recidivism after treatment, a 2011 retrospective study of a treatment program in the 1960s, had several serious methodological problems and likely would not be approved of today. However, some relatively rigorous quasi-experimental studies using more modern treatment methods have found improvements regarding reducing future violent and other criminal behavior, regardless of PCL-R scores, although none were randomized controlled trials. Various other studies have found improvements in risk factors for crime such as substance abuse. No study has of yet in a 2013 review examined if the personality traits that form the core character disturbances of psychopathy could be changed by such treatments.

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.

A 2008 study using the PCL:SV found that 1.2% of a US sample scored 13 or more out of 24, indicating "potential psychopathy". The scores correlated significantly with violence, alcohol use, and lower intelligence. A 2009 British study by Coid et al., also using the PCL:SV, reported a community prevalence of 0.6% scoring 13 or more. The scores correlated with younger age, male gender, suicide attempts, violence, imprisonment, homelessness, drug dependence, personality disorders (histrionic, borderline and antisocial), and panic and obsessive–compulsive disorders.

Psychopathy has a much higher prevalence in the convicted and incarcerated population, where it is thought that an estimated 15–25% of prisoners qualify for the diagnosis. A study on a sample of inmates in the UK found that 7.7% of the inmates interviewed met the PCL-R cut-off of 30 for a diagnosis of psychopathy. A study on a sample of inmates in Iran using the PCL:SV found a prevalence of 23% scoring 18 or more.

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.

Biastophilia (from Greek "biastes", "rape" + "-philia") and its Latin language-derived counterpart raptophilia (from Latin "rapere", "to seize"), also paraphilic rape, is a paraphilia in which sexual arousal is dependent on, or is responsive to, the act of assaulting an unconsenting person, especially a stranger. Some dictionaries consider the terms synonymous, while others distinguish raptophilia as the paraphilia in which sexual arousal is responsive to actually raping the victim.

The source of the arousal in these paraphilias is the victim's terrified resistance to the assault, and in this respect it is considered to be a form of sexual sadism. Biastophilia is accepted as potentially lethal, other such paraphilias including, but not being limited to asphyxiophilia, autassassinophilia, hybristophilia, and chremastistophilia.

Under the name paraphilic coercive disorder, this diagnosis was proposed for inclusion in DSM-5. This diagnosis, under the name "paraphilic rapism", was proposed and rejected in the DSM-III-R. It has been criticized because of the impossibility of reliably distinguishing between paraphilic rapists and non-paraphilic rapists, and because this diagnosis, under the term "Paraphilia NOS" (not otherwise specified), non-consent had been used in Sexually Violent Person/Predator commitment.

Czech sexology standardly use a concept of pathologic sexual aggressivity instead. This term is strongly distinguished from sadism. This disorder is understood as a coordination anomaly of the sexual motivation system (SMS), a "courtship disorder" according to Kurt Freund or displacement paraphilia by John Money, or a missing segment of SMS.

Three key terms commonly used in regards to the subject — "zoophilia", "bestiality", and "zoosexuality" — are often used somewhat interchangeably. Some researchers distinguish between zoophilia (as a persistent sexual interest in animals) and bestiality (as sexual acts with animals), because bestiality is often not driven by a sexual preference for animals. Some studies have found that a preference for animals is rare among people who engage in sexual contact with animals. Furthermore, some zoophiles report that they have never had sexual contact with an animal. People with zoophilia are known as "zoophiles", though also sometimes as "zoosexuals", or even very simply "zoos". Zooerasty, sodomy, and zooerastia are other terms closely related to the subject but are less synonymous with the former terms, and are seldom used. "Bestiosexuality" was discussed briefly by Allen (1979), but never became widely established. Ernest Bornemann (1990, cited by Rosenbauer, 1997) coined the separate term "zoosadism" for those who derive pleasure – sexual or otherwise – from inflicting pain on animals. Zoosadism specifically is one member of the Macdonald triad of precursors to sociopathic behavior.

In the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), recurrent, intense sexual interest in corpses can be diagnosed under Other Specified Paraphilic Disorder (necrophilia) when it causes marked distress or impairment in important areas of functioning. A ten-tier classification of necrophilia exists:

1. Role players: People who get aroused from pretending their live partner is dead during sexual activity.

2. Romantic necrophiliacs: Bereaved people who remain attached to their dead lover's body.

3. Necrophilic fantasizers: People who fantasize about necrophilia, but never actually have sex with a corpse.

4. Tactile necrophiliacs: People who are aroused by touching or stroking a corpse, without engaging in intercourse.

5. Fetishistic necrophiliacs: People who remove objects (e.g., panties or a tampon) or body parts (e.g., a finger or genitalia) from a corpse for sexual purposes, without engaging in intercourse.

6. Necromutilomaniacs: People who derive pleasure from mutilating a corpse while masturbating, without engaging in intercourse.

7. Opportunistic necrophiliacs: People who normally have no interest in necrophilia, but take the opportunity when it arises.

8. Regular necrophiliacs: People who preferentially have intercourse with the dead.

9. Homicidal necrophiliacs: Necrosadists, people who commit murder in order to have sex with the victim.

10. Exclusive necrophiliacs: People who have an exclusive interest in sex with the dead, and cannot perform at all for living partners.

Gynophobia or gynephobia is an abnormal fear of women, a type of specific social phobia. In the past, the Latin term horror feminae was used.

Gynophobia should not be confused with misogyny, the hatred, contempt for and inveterate prejudice against women, although some may use the terms interchangeably, in reference to the social, rather than pathological aspect of negative attitudes towards women.

An antonym is philogyny, the love, respect for and admiration of women.

Until the 1990s, it tended to be described mostly as acrotomophilia, at the expense of other disabilities, or of the wish by some to pretend or acquire disability. Bruno (1997) systematised the attraction as factitious disability disorder. A decade on, others argue that erotic target location error is at play, classifying the attraction as an identity disorder. In the standard psychiatric reference "Diagnostic and Statistical Manual of Mental Disorders", text revision (DSM-IV-tr), the fetish falls under the general category of "Sexual and Gender Identity Disorders" and the more specific category of paraphilia, or sexual fetishes; this classification is preserved in DSM-5.

Necrophilia is often assumed to be rare, but no data for its prevalence in the general population exists. Some necrophiles only fantasize about the act, without carrying it out. In 1958, Klaf and Brown commented that, although rarely described, necrophiliac fantasies may occur more often than is generally supposed.

Rosman and Resnick (1989) reviewed 122 cases of necrophilia. The sample was divided into genuine necrophiles, who had a persistent attraction to corpses, and pseudo-necrophiles, who acted out of opportunity, sadism, or transient interest. Of the total, 92% were male and 8% were female. 57% of the genuine necrophiles had occupational access to corpses, with morgue attendant, hospital orderly, and cemetery employee being the most common jobs. The researchers theorized that either of the following situations could be antecedents to necrophilia:

1. The necrophile develops poor self-esteem, perhaps due in part to a significant loss;

- (a) They are very fearful of rejection by others and they desire a sexual partner who is incapable of rejecting them; and/or

- (b) They are fearful of the dead, and transform their fear—by means of reaction formation—into a desire.

2. They develop an exciting fantasy of sex with a corpse, sometimes after exposure to a corpse.

The authors reported that, of their sample of genuine necrophiles:

- 68% were motivated by a desire for an unresisting and unrejecting partner;

- 21% by a want for reunion with a lost partner;

- 15% by sexual attraction to dead people;

- 15% by a desire for comfort or to overcome feelings of isolation; and

- 12% by a desire to remedy low self-esteem by expressing power over a corpse.

IQ data was limited, but not abnormally low. About half of the sample had a personality disorder, and 11% of true necrophiles were psychotic. Rosman and Resnick concluded that their data challenged the conventional view of necrophiles as generally psychotic, mentally deficient, or unable to obtain a consenting partner.

Sadism involves gaining pleasure through themselves or others undergoing discomfort or pain. The opponent-process theory explains the way in which individuals not only display, but also enjoy committing sadistic acts. Individuals possessing sadistic personalities tend to display recurrent aggression and cruel behavior. Sadism can also include the use of emotional cruelty, purposefully manipulating others through the use of fear, and a preoccupation with violence.

Theodore Millon claimed there were four subtypes of sadism, which he termed Enforcing sadism, Explosive sadism, Spineless sadism, and Tyrannical sadism.

Attraction to disability or devotism is a sexualised interest in the appearance, sensation and experience of disability. It may extend from normal human sexuality into a type of sexual fetishism. Sexologically, the pathological end of the attraction tends to be classified as a paraphilia. (Note, however, that the very concept "paraphilia" continues to elude satisfactory definition and remains a subject of ongoing debate in both professional and lay communities) Other researchers have approached it as a form of identity disorder. The most common interests are towards amputations, prosthesis, and crutches.

Sadistic personality disorder has been found to occur frequently in unison with other personality disorders. Studies have also found that sadistic personality disorder is the personality disorder with the highest level of comorbidity to other types of psychopathological disorders. In contrast, sadism has also been found in patients who do not display any or other forms of psychopathic disorders. One personality disorder that is often found to occur alongside sadistic personality disorder is conduct disorder, not an adult disorder but one of childhood and adolescence. Studies have found other types of illnesses, such as alcoholism, to have a high rate of comorbidity with sadistic personality disorder.

Researchers have had some level of difficulty distinguishing sadistic personality disorder from other forms of personality disorders due to its high level of comorbidity with other disorders.

Child abuse and neglect consistently show up as risk factors to the development of personality disorders in adulthood. A study looked at retrospective reports of abuse of participants that had demonstrated psychopathology throughout their life and were later found to have past experience with abuse. In a study of 793 mothers and children, researchers asked mothers if they had screamed at their children, and told them that they did not love them or threatened to send them away. Children who had experienced such verbal abuse were three times as likely as other children (who did not experience such verbal abuse) to have borderline, narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood. The sexually abused group demonstrated the most consistently elevated patterns of psychopathology. Officially verified physical abuse showed an extremely strong correlation with the development of antisocial and impulsive behavior. On the other hand, cases of abuse of the neglectful type that created childhood pathology were found to be subject to partial remission in adulthood.

Socioeconomic status has also been looked at as a potential cause for personality disorders. There is a strong association with low parental/neighborhood socioeconomic status and personality disorder symptoms. In a recent study comparing parental socioeconomic status and a child's personality, it was seen that children who were from higher socioeconomic backgrounds were more altuistic, less risk seeking, and had overall higher IQs. These traits correlate with a low risk of developing personality disorders later on in life. In a study looking at female children who were detained for disciplinary actions found that psychological problems were most negatively associated with socioeconomic problems. Furthermore, social disorganization was found to be inversely correlated with personality disorder symptoms.

According to Anil Aggrawal, in forensic science, levels of sexual sadism and masochism are classified as follows:

Sexual masochists:

- "Class I": Bothered by, but not seeking out, fantasies. May be preponderantly sadists with minimal masochistic tendencies or non-sadomasochistic with minimal masochistic tendencies

- "Class II": Equal mix of sadistic and masochistic tendencies. Like to receive pain but also like to be dominant partner (in this case, sadists). Sexual orgasm is achieved without pain or humiliation.

- "Class III": Masochists with minimal to no sadistic tendencies. Preference for pain or humiliation (which facilitates orgasm), but not necessary to orgasm. Capable of romantic attachment.

- "Class IV": Exclusive masochists (i.e. cannot form typical romantic relationships, cannot achieve orgasm without pain or humiliation).

Sexual sadists:

- "Class I": Bothered by sexual fantasies but do not act on them.

- "Class II": Act on sadistic urges with consenting sexual partners (masochists or otherwise). Categorization as leptosadism is outdated.

- "Class III": Act on sadistic urges with non-consenting victims, but do not seriously injure or kill. May coincide with sadistic rapists.

- "Class IV": Only act with non-consenting victims and will seriously injure or kill them.

The difference between I–II and III–IV is consent.