The DSM-IV-TR criteria was criticized simultaneously for being over-inclusive, as well as under-inclusive. Though most researchers distinguish between child molesters and pedophiles, Studer and Aylwin argue that the DSM criteria are over-inclusive because all acts of child molestation warrant the diagnosis. A child molester satisfies criteria A because of the behavior involving sexual activity with prepubescent children and criteria B because the individual has acted on those urges. Furthermore, they argue that it also is under-inclusive in the case of individuals who do not act upon it and are not distressed by it. The latter point has also been made by several other researchers who have remarked that a so-called "contented pedophile"—an individual who fantasizes about having sex with a child and masturbates to these fantasies, but does not commit child sexual abuse, and who does not feel subjectively distressed afterward—does not meet the DSM-IV-TR criteria for pedophilia, because this person does not meet Criterion B. A large-scale survey about usage of different classification systems showed that the DSM classification is only rarely used. As an explanation, it was suggested that the under-inclusiveness, as well as a lack of validity, reliability and clarity might have led to the rejection of the DSM classification.

Ray Blanchard, an American-Canadian sexologist known for his research studies on pedophilia, addressed (in his literature review for the DSM-5) the aforementioned objections to the DSM-IV-TR, and proposed a general solution applicable to all paraphilias. This meant namely a distinction between "paraphilia" and "paraphilic disorder". The latter term is proposed to identify the diagnosable mental disorder which meets Criterion A and B, whereas an individual who does not meet Criterion B can be ascertained but "not" diagnosed as having a paraphilia. Blanchard and a number of his colleagues also proposed that hebephilia become a diagnosable mental disorder under the DSM-5 to resolve the physical development overlap between pedophilia and hebephilia by combining the categories under "pedophilic disorder", but with specifiers on which age range (or both) is the primary interest. The proposal for hebephilia was rejected by the American Psychiatric Association, but the distinction between "paraphilia" and "paraphilic disorder" was implemented.

The American Psychiatric Association stated that "[i]n the case of pedophilic disorder, the notable detail is what wasn't revised in the new manual. Although proposals were discussed throughout the DSM-5 development process, diagnostic criteria ultimately remained the same as in DSM-IV TR" and that "[o]nly the disorder name will be changed from pedophilia to pedophilic disorder to maintain consistency with the chapter’s other listings." If hebephilia had been accepted as a DSM-5 diagnosable disorder, it would have been similar to the ICD-10 definition of pedophilia that already includes early pubescents, and would have raised the minimum age required for a person to be able to be diagnosed with pedophilia from 16 years to 18 years (with the individual needing to be at least 5 years older than the minor).

O'Donohue, however, suggests that the diagnostic criteria for pedophilia be simplified to the attraction to children alone if ascertained by self-report, laboratory findings, or past behavior. He states that any sexual attraction to children is pathological and that distress is irrelevant, noting "this sexual attraction has the potential to cause significant harm to others and is also not in the best interests of the individual." Also arguing for behavioral criteria in defining pedophilia, Howard E. Barbaree and Michael C. Seto disagreed with the American Psychiatric Association's approach in 1997 and instead recommended the use of actions as the sole criterion for the diagnosis of pedophilia, as a means of taxonomic simplification.

The "Diagnostic and Statistical Manual of Mental Disorders" 5th edition (DSM-5) has a significantly larger diagnostic features section for pedophilia than the previous DSM version, the DSM-IV-TR, and states, "The diagnostic criteria for pedophilic disorder are intended to apply both to individuals who freely disclose this paraphilia and to individuals who deny any sexual attraction to prepubertal children (generally age 13 years or younger), despite substantial objective evidence to the contrary." Like the DSM-IV-TR, the manual outlines specific criteria for use in the diagnosis of this disorder. These include the presence of sexually arousing fantasies, behaviors or urges that involve some kind of sexual activity with a prepubescent child (with the diagnostic criteria for the disorder extending the cut-off point for prepubescence to age 13) for six months or more, or that the subject has acted on these urges or suffers from distress as a result of having these feelings. The criteria also indicate that the subject should be 16 or older and that the child or children they fantasize about are at least five years younger than them, though ongoing sexual relationships between a 12- to 13-year-old and a late adolescent are advised to be excluded. A diagnosis is further specified by the sex of the children the person is attracted to, if the impulses or acts are limited to incest, and if the attraction is "exclusive" or "nonexclusive".

The ICD-10 defines pedophilia as "a sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age". Like the DSM, this system's criteria require that the person be at least 16 years of age or older before being diagnosed as a pedophile. The person must also have a persistent or predominant sexual preference for prepubescent children at least five years younger than them.

Several terms have been used to distinguish "true pedophiles" from non-pedophilic and non-exclusive offenders, or to distinguish among types of offenders on a continuum according to strength and exclusivity of pedophilic interest, and motivation for the offense (see child sexual offender types). Exclusive pedophiles are sometimes referred to as "true pedophiles." They are sexually attracted to prepubescent children, and only prepubescent children. Showing no erotic interest in adults, they can only become sexually aroused while fantasizing about or being in the presence of prepubescent children, or both. Non-exclusive offenders—or "non-exclusive pedophiles"—may at times be referred to as "non-pedophilic" offenders, but the two terms are not always synonymous. Non-exclusive offenders are sexually attracted to both children and adults, and can be sexually aroused by both, though a sexual preference for one over the other in this case may also exist. If the attraction is a sexual preference for prepubescent children, such offenders are considered pedophiles in the same vein as exclusive offenders.

Neither the DSM nor the ICD-10 diagnostic criteria require actual sexual activity with a prepubescent youth. The diagnosis can therefore be made based on the presence of fantasies or sexual urges even if they have never been acted upon. On the other hand, a person who acts upon these urges yet experiences no distress about their fantasies or urges can also qualify for the diagnosis. "Acting" on sexual urges is not limited to overt sex acts for purposes of this diagnosis, and can sometimes include indecent exposure, voyeuristic or frotteuristic behaviors, or masturbating to child pornography. Often, these behaviors need to be considered in-context with an element of clinical judgment before a diagnosis is made. Likewise, when the patient is in late adolescence, the age difference is not specified in hard numbers and instead requires careful consideration of the situation.

Ego-dystonic sexual orientation () includes people who acknowledge that they have a sexual preference for prepubertal children, but wish to change it due to the associated psychological or behavioral problems (or both).

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.

The following are some of the partialisms commonly found among people:

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.

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.'"

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.

Partialism is sexual interest with an exclusive focus on a specific part of the body other than the genitals. Partialism is categorized as a fetishistic disorder in the DSM-5 of the American Psychiatric Association only if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life. In the DSM-IV, it was considered a separate paraphilia (not otherwise specified), but was merged into fetishistic disorder by the DSM-5. Individuals who exhibit partialism sometimes describe the anatomy of interest to them as having equal or greater erotic attraction for them as do the genitals.

Partialism occurs in heterosexual, bisexual, and homosexual individuals. The foot is considered one of the most common partialisms.

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.

Vorarephilia (often shortened to vore) is a paraphilia characterized by the erotic desire to be consumed by, or sometimes to personally consume, another person or creature, or an erotic attraction to the process of eating in general. Since vorarephilic fantasies cannot usually be acted out in reality, they are often expressed in stories or drawings shared on the Internet. The word "vorarephilia" is derived from the Latin "vorare" (to "swallow" or "devour"), and Ancient Greek φιλία ("philía", "love").

The fantasy usually involves the victim being swallowed whole, though occasionally the victims are chewed up, and digestion may or may not be included. Vore fantasies are separated from sexual cannibalism because the living victim is normally swallowed whole. Sometimes the consumers are human, but anthropormorphized animals, dragons, and enormous snakes also appear frequently in these fantasies. After consumption, the enlarged belly of the consumer is often described with great care. Vorarephiles sometimes prefer to differentiate between "soft vore" and "hard vore"; soft vore means the victim is swallowed whole and alive, and may possibly come back out in the case of a "non-fatal" scenario, while in hard vore the victim goes through a more gruesome, realistic digestion process, often getting chewed up beforehand.

Vore is most often enjoyed through pictures, stories, videos, and video games, and it can appear in mainstream media. In some cases, vorarephilia may be described as a variation of macrophilia and may combine with other paraphilias. Apart from macrophilia, vore fantasies often have themes of BDSM, microphilia, pregnancy fetishism, furry fetishism, "unbirthing" (a desire to be swallowed whole into the vagina and returned to the uterus), and sexual cannibalism.

One case study analysis connected the fantasy with sexual masochism, and suggested that it could be motivated by a desire to merge with a powerful other or permanently escape loneliness. With "no known treatment" for vorarephiles who feel ill at ease with their sexuality, psychologists at Toronto's Centre for Addiction and Mental Health have recommended trying to "adjust to, rather than change or suppress" the sexual interest. Medication for sex drive reduction could be used if deemed necessary.

Exhibitionism is the act of exposing in a public or semi-public context those parts of one's body that are not normally exposed – for example, the breasts, genitals or buttocks. The practice may arise from a desire or compulsion to expose themselves in such a manner to groups of friends or acquaintances, or to strangers for their amusement or sexual satisfaction or to shock the bystander. Exposing oneself only to an intimate partner is normally not regarded as exhibitionism. In law, the act of exhibitionism may be called indecent exposure, "exposing one's person", or other expressions.

Robot fetishism (also ASFR or technosexuality) is a fetishistic attraction to humanoid robots; also to people acting like robots or people dressed in robot costumes. A less common fantasy involves transformation into a robot. In these ways it is similar to agalmatophilia, which involves attraction to or transformation into statues or mannequins.

Robot fetishism can be viewed as a form of erotic anthropomorphism. When transformation or roleplaying is involved it can be thought of as a form of erotic objectification.

Mechanophilia (or mechaphilia) is a paraphilia involving a sexual attraction to machines such as bicycles, motor vehicles, helicopters, ships, and aeroplanes.

Mechanophilia is treated as a crime in some nations with perpetrators being placed on a sex-offenders' register after prosecution. Motorcycles are often portrayed as sexualized fetish objects to those who desire them.

A disability pretender is subculture term meaning a person who behaves as if he or she were disabled. It may be classified as a type of factitious disorder or as a medical fetishism.

One theory is that pretenders may be the "missing link" between devotees and wannabes, demonstrating an assumed continuum between those merely attracted to people with disabilities and those who actively wish to become disabled. Many wannabes use pretending as a way to appease the intense emotional pain related to having body integrity identity disorder.

Pretending takes a variety of forms. Some chatroom users on internet sites catering to devotees have complained that chat counterparts they assumed were female were revealed as male devotees. This form of pretending (where a devotee derives pleasure by pretending to be a disabled woman) may indicate a very broad predisposition to pretending among devotees.

Pretending includes dressing and acting in ways typical of disabled people, including making use of aids (Walking sticks, crutches, wheelchairs, mobility scooters, white canes, etc. Pretending may also take the form of a devotee persuading his or her sexual partner to play the role of a disabled person. Pretending may be practiced in private, in intimacy, or in public, and may occupy surprisingly long periods. In the latter case, some pretenders hope that the disability may become permanent, such as through tissue necrosis caused by constricted blood supply.

Anesthesia fetish is considered edgeplay when realised outside the boundaries of fantasy, and may result in various degrees of harm, or death. Fantasies are elaborated by the viewing of images and reading of stories of anesthetic inductions. Edgeplay may involve obtaining and scening with various anesthesia-related paraphernalia—usually anesthesia masks for breathplay, the acquisition of anesthetics for anesthetizing others or being anesthetized oneself, and the occupation of a medical setting or environment for the same practice.

Some anesthesia fetishists who seek to be anesthetized may feign or induce medical conditions in an attempt to obtain general anesthesia from medical personnel. This is considered safer than playing with anesthetic agents outside of a medical setting, but may nevertheless be an abuse of all concerned.

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

Jennifer Eve Rehor of San Francisco State University points out that such data as exists on what she calls "unconventional" or "kink" sexual behavior is generally problematic because of the way that it has been collected, through criminal and clinical case studies. Behavior that appears neither in criminal trials nor in clinical studies (for example, because the individuals concerned do not commonly seek professional help) is therefore under-reported. Rehor therefore surveyed 1,764 female participants in "kink" behavior (mostly association with BDSM) in 2010-11, receiving 1,580 valid responses. What Rehor calls "urine play" is relatively infrequent, with only 36.52% of her sample reporting having done it or having had it done to them. In contrast, 93.99% of her sample reported having done spanking or having had it done to them, and 61.96% reported having used or been exposed to feathers/fur. It is impossible to extrapolate Rehor's data onto the general population, but her study does give a guide to prevalence in the North American BDSM community.

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.

Mysophilia relates to soiled or dirty material or people. Mysophiliacs may find dirt, soiled underwear, feces, or vomit to be sexually arousing.

It is possible for people with mysophilia to be aroused by unclean locales, such as an alleyway, or a dirty room/bathroom; wearing the same clothing for many days at a time; or not bathing, from mere days to several weeks.

Agalmatophilia (from the Greek "agalma" 'statue', and -philia φιλία = love) is a paraphilia involving sexual attraction to a statue, doll, mannequin or other similar figurative object. The attraction may include a desire for actual sexual contact with the object, a fantasy of having sexual (or non-sexual) encounters with an animate or inanimate instance of the preferred object, the act of watching encounters between such objects, or sexual pleasure gained from thoughts of being transformed or transforming another into the preferred object. Agalmatophilia may also encompass "Pygmalionism" (from the myth of Pygmalion), which denotes love for an object of one's own creation.

Diaper fetishism, nappy fetishism or diaperism, is a type of garment fetish or paraphilic infantilism. A person with a diaper fetish derives pleasure from the diaper and/or use of it. Being forced to wear diapers as a form of humiliation is sometimes a behavior encountered in sexual masochism.

It is important to note that the diaper fetish community actively opposes and condemns child molesters. Both men and women can practice diaper fetishes, both inside and outside a relationship. As of September 2015, Huffington Post Arts & Culture published an interview on diaper fetishes that was widely regarded as informative within the community. While this clothing fetish is obscure, diaper fetishists engage in the behavior privately or with a partner who shares a mutual interest in the fetish.

Underwear fetishism is a sexual fetishism relating to undergarments, and refers to preoccupation with the sexual excitement of certain types of underwear, including panties, stockings, pantyhose, bras, or other items. Some people experience sexual excitement from wearing, while others get their excitement when observing or handling the underwear worn by another, or watching somebody putting underwear on/taking it off. Some may steal used underwear to get satisfaction. Not only does this include physical contact with the garment(s), or their wearers, but also includes arousal by printed or electronic image with depictions of underwear.

Underwear fetishism is not considered as paraphilia unless it causes distress or serious problems for the person or those associated with them.

Public exhibitionism by women has been recorded since classical times, often in the context of women shaming groups of men into committing, or inciting them to commit, some public action. The ancient Greek historian Herodotus gives an account of exhibitionistic behaviors from the fifth century BC in "The Histories". Herodotus writes that: When people travel to Bubastis for the festival, this is what they do. Every "baris" carrying them there overflows with people, a huge crowd of them, men and women together. Some of the women have clappers, while some of the men have pipes which they play throughout the voyage. The rest of the men and women sing and clap their hands. When in the course of their journey they reach a community — not the city of their destination, but somewhere else — they steer the "bareis" close to the bank. Some of the women carry on doing what I have already described them as doing, but others shout out scornful remarks to the women in the town, or dance, or stand and pull up their clothes to expose themselves. Every riverside community receives this treatment.

A case of what appears to be exhibitionism in a clinical sense was recorded in a report by the Commission against Blasphemy in Venice in 1550.

In the UK the 4th draft of the revised Vagrancy Act of 1824 included an additional clause 'or openly and indecently exposing their persons' which gave rise to difficulties because of its ill-defined scope. During the course of a subsequent debate on the topic in Parliament, the then Home Secretary, Mr Peel, observed that 'there was not a more flagrant offence than that of indecently exposing the person which had been carried to an immense extent in the parks...wanton exposure was a very different thing from accidental exposure'. The development of new technologies such as smartphones and tablets has permitted some exhibitionists to reorient their methods such as with .

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.

Spectrophilia is sexual attraction to ghosts or sexual arousal from images in mirrors, as well as the phenomenon of sexual encounters between ghosts and humans.