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 fetishism is not known with certainty. The majority of fetishists are male. In a 2011 study, 30% of men reported fetishistic fantasies, and 24.5% had engaged in fetishistic acts. Of those reporting fantasies, 45% said the fetish was intensely sexually arousing. In a 2014 study, 26.3% of women and 27.8% of men acknowledged any fantasies about "having sex with a fetish or non-sexual object". A content analysis of the sample's favorite fantasies found that 14% of the male fantasies involved fetishism (including feet, nonsexual objects, and specific clothing), and 4.7% focused on a specific body part other than feet. None of the women's favorite fantasies had fetishistic themes. Another study found that 28% of men and 11% of women reported fetishistic arousal (including feet, fabrics, and objects "like shoes, gloves, or plush toys"). 18% of men in a 1980 study reported fetishistic fantasies.

Fetishism to the extent that it becomes a disorder appears to be rare, with less than 1% of general psychiatric patients presenting fetishism as their primary problem. It is also uncommon in forensic populations.

Fetishism usually becomes evident during puberty, and may develop prior to that. No cause for fetishism has been conclusively established.

Some explanations invoke classical conditioning. In several experiments, men have been conditioned to show arousal to stimuli like boots, geometric shapes or penny jars by pairing these cues with conventional erotica. According to John Bancroft, conditioning alone cannot explain fetishism, because it does not result in fetishism for most people. He suggests that conditioning combines with some other factor, such as an abnormality in the sexual learning process.

Theories of sexual imprinting propose that humans learn to recognize sexually desirable features and activities during childhood. Fetishism could result when a child is imprinted with an overly narrow or "incorrect" concept of a sex object. Imprinting seems to occur during the child's earliest experiences with arousal and desire, and is based on "an egocentric evaluation of salient reward- or pleasure-related characteristics that differ from one individual to another."

Neurological differences may play a role in some cases. Vilayanur S. Ramachandran observed that the region processing sensory input from the feet lies immediately next to the region processing genital stimulation, and suggested an accidental link between these regions could explain the prevalence of foot fetishism. In one unusual case, an anterior temporal lobectomy relieved an epileptic man's fetish for safety pins.

Various explanations have been put forth for the rarity of female fetishists. Most fetishes are visual in nature, and males are thought to be more sexually sensitive to visual stimuli. Roy Baumeister suggests that male sexuality is unchangeable, except for a brief period in childhood during which fetishism could become established, while female sexuality is fluid throughout life.

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.

Paraphilia (previously known as sexual perversion and sexual deviation) is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals. Such attraction may be labeled sexual fetishism. No consensus has been found for any precise border between unusual sexual interests and paraphilic ones. There is debate over which, if any, of the paraphilias should be listed in diagnostic manuals, such as the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) or the International Classification of Diseases (ICD).

The number and taxonomy of paraphilia is under debate; one source lists as many as 549 types of paraphilia. The DSM-5 has specific listings for eight paraphilic disorders. Several sub-classifications of the paraphilias have been proposed, and some argue that a fully dimensional, spectrum or complaint-oriented approach would better reflect the evidence.

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.

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.

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.

Due to the prevalence of voyeurism in society, the people who engage in voyeuristic behaviors are diverse. However, there are some trends regarding who is likely to engage in voyeurism. These statistics apply only to those who qualify as voyeurs under the definition of the DSM, and not the broader modern concept of voyeurism as discussed earlier in this article.

Early research indicated that voyeurs were more mentally healthy than other groups with paraphilias. Compared to the other groups studied, it was found that voyeurs were unlikely to be alcoholics or drug users. More recent research shows that, compared to the general population, voyeurs were moderately more likely to have psychological problems, use alcohol and drugs, and have higher sexual interest generally. This study also shows that voyeurs have a greater number of sexual partners per year, and are more likely to have had a same-sex partner than general populations. Both older and newer research found that voyeurs typically have a later age of first sexual intercourse. However, other research found no difference in sexual history between voyeurs and non-voyeurs. Voyeurs who are not also exhibitionists tend to be from a higher socioeconomic status than those who do show exhibitionist behavior.

Research shows that, like almost all paraphilias, voyeurism is more common in men than in women. However, research has found that men and women both report roughly the same likelihood that they would hypothetically engage in voyeurism. There appears to be a greater gender difference when actually presented with the opportunity to perform voyeurism. There is very little research done on voyeurism in women, so very little is known on the subject. One of the few studies deals with a case study of a woman who also had schizophrenia. This limits the degree to which it can generalize to normal populations.

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.

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.

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.

Voyeurism has high prevalence rates in most studied populations. Voyeurism was initially believed to only be present in a small portion of the population. This perception changed when Alfred Kinsey discovered that 30% of men prefer coitus with the lights on. This behavior is not considered voyeurism by today's diagnostic standards, but there was little differentiation between normal and pathological behavior at the time. Subsequent research showed that 65% of men had engaged in peeping, which suggests that this behavior is widely spread throughout the population. Congruent with this, research found voyeurism to be the most common sexual law-breaking behavior in both clinical and general populations. In the same study it was found that 42% of college males who had never been convicted of a crime had watched others in sexual situations. An earlier study indicates that 54% of men have voyeuristic fantasies, and that 42% have tried voyeurism. In a national study of Sweden it was found that 7.7% of the population (both men and women) had engaged in voyeurism at some point. It is also believed that voyeurism occurs up to 150 times more frequently than police reports indicate. This same study also indicates that there are high levels of co-occurrence between voyeurism and exhibitionism, finding that 63% of voyeurs also report exhibitionist behavior.

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.

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.

Spectrophilia is a fetish that is classified as the paraphilia in which one is attracted to ghosts or spirits. Spectrophiliacs fantasize about ghosts and often imagine scenarios involving sexual events between themselves or others and spirits.

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

Medical fetishism refers to a number of sexual fetishes involving objects, practices, environments, and situations of a medical or clinical nature. In sexual roleplay a hospital or medical scene involves the sex partners assuming the roles of doctors, nurses, surgeons and patients to act out specific or general medical fetishes. Medical fantasy is a genre in pornography, though the fantasy may not necessarily involve pornography or sexual activity.

Medical fetishism may involve sexual attraction to respiratory therapy involving oxygen via nasal cannula or any sort of masks, medical practitioners, medical uniforms, hospital gowns, anaesthesia, intimate examinations (such as rectal examination, gynecological examination, urological examination, andrological examination, rectal temperature-taking), catheterization, diapering, enemas, injections, insertion (such as suppository insertion, menstrual-cup insertion, and prostatic massage), medical devices (such as orthopedic casts and orthopedic braces; see also "Abasiophilia"), dental objects (such as dental braces, retainers, and headgear), medical restraints, and medical gags.

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.

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

The Internet has enabled people with this relatively rare paraphilia to discuss the subject and exchange anesthesia-related multimedia.

HSDD was listed under the Sexual and Gender Identity Disorders of the DSM-IV. In the DSM-5, it was split into male hypoactive sexual desire disorder and female sexual interest/arousal disorder. It was first included in the DSM-III under the name inhibited sexual desire disorder, but the name was changed in the DSM-III-R. Other terms used to describe the phenomenon include sexual aversion and sexual apathy. More informal or colloquial terms are "frigidity" and "frigidness".

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.

A number of studies have explored the factors that contribute to female sexual arousal disorder and female orgasmic disorder. These factors include both psychological and physical factors. Psychologically, possible causes of the disorder include the impact of childhood and adolescence experiences and current events – both within the individual and within the current relationship.