The ICD-10 defines fetishism as a reliance on non-living objects for sexual arousal and satisfaction. It is only considered a disorder when fetishistic activities are the foremost source of sexual satisfaction, and become so compelling or unacceptable as to cause distress or interfere with normal sexual intercourse. The ICD's research guidelines require that the preference persists for at least six months, and is markedly distressing or acted on.

Under the DSM-5, fetishism is sexual arousal from nonliving objects or specific nongenital body parts, excluding clothes used for cross-dressing (as that falls under transvestic disorder) and sex toys that are designed for genital stimulation. In order to be diagnosed as "fetishistic disorder", the arousal must persist for at least six months and cause significant psychosocial distress or impairment in important areas of their life. In the DSM-IV, sexual interest in body parts was distinguished from fetishism under the name partialism (diagnosed as Paraphilia NOS), but it was merged with fetishistic disorder for the DSM-5.

The ReviseF65 project has campaigned for the ICD diagnosis to be abolished completely to avoid stigmatizing fetishists. Sexologist Odd Reiersøl argues that distress associated with fetishism is often caused by shame, and that being subject to diagnosis only exacerbates that. He suggests that, in cases where the individual fails to control harmful behavior, they instead be diagnosed with a personality or impulse control disorder.

According to the World Health Organization, fetishistic fantasies are common and should only be treated as a disorder when they impair normal functioning or cause distress. Goals of treatment can include elimination of criminal activity, reduction in reliance on the fetish for sexual satisfaction, improving relationship skills, or attempting to remove deviant arousal altogether. The evidence for treatment efficacy is limited and largely based on case studies, and no research on treatment for female fetishists exists.

Cognitive behavioral therapy is one popular approach. Cognitive behavioral therapists teach clients to identify and avoid antecedents to fetishistic behavior, and substitute non-fetishistic fantasies for ones involving the fetish. Aversion therapy can reduce fetishistic arousal in the short term, but is unlikely to have any permanent effect.

Antiandrogens and selective serotonin reuptake inhibitors (SSRIs) may be prescribed to lower sex drive. Cyproterone acetate is the most commonly used antiandrogen, except in the United States, where it may not be available. A large body of literature has shown that it reduces general sexual fantasies. Side effects may include osteoporosis, liver dysfunction, and feminization. Case studies have found that the antiandrogen medroxyprogesterone acetate is successful in reducing sexual interest, but can have side effects including osteoporosis, diabetes, deep vein thrombosis, feminization, and weight gain. Some hospitals use leuprolide acetate and goserelin acetate to reduce libido, and while there is presently little evidence for their efficacy, they have fewer side effects than other antiandrogens. A number of studies support the use of SSRIs, which may be preferable over antiandrogens because of their relatively benign side effects. None of these drugs cure sexual fetishism, but they can make it easier to manage.

Relationship counselers may attempt to reduce dependence on the fetish and improve partner communication using techniques like sensate focusing. Partners may agree to incorporate the fetish into their activities in a controlled, time-limited manner, or set aside only certain days to practice the fetishism. If the fetishist cannot sustain an erection without the fetish object, the therapist might recommend orgasmic reconditioning or covert sensitization to increase arousal to normal stimuli (although the evidence base for these techniques is weak).

Antiandrogens are used in more severe cases. Similar to physical castration, they work by reducing androgen levels, and have thus been described as chemical castration. The antiandrogen cyproterone acetate has been shown to substantially reduce sexual fantasies and offending behaviors. Medroxyprogesterone acetate and gonadotropin-releasing hormone agonists (such as leuprolide acetate) have also been used to lower sex drive. Due to the side effects, the World Federation of Societies of Biological Psychiatry recommends that hormonal treatments only be used when there is a serious risk of sexual violence, or when other methods have failed. Surgical castration has largely been abandoned because these pharmacological alternatives are similarly effective and less invasive.

Most psychologists believe that paraphilic sexual interests cannot be altered. Instead, the goal of therapy is normally to reduce the person's discomfort with their paraphilia and limit any criminal behavior. Both psychotherapeutic and pharmacological methods are available to these ends.

Cognitive behavioral therapy, at times, can help people with paraphilias develop strategies to avoid acting on their interests. Patients are taught to identify and cope with factors that make acting on their interests more likely, such as stress. It is currently the only form of psychotherapy for paraphilias supported by evidence.

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 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.

A fetish (derived from the French "fétiche"; which comes from the Portuguese "feitiço"; and this in turn from Latin "facticius", "artificial" and "facere", "to make") is an object believed to have supernatural powers, or in particular, a human-made object that has power over others. Essentially, fetishism is the emic attribution of inherent value or powers to an object.

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.

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.

Acrotomophiles may be attracted to amputees because they like the way they look or they may view the amputee’s stump as a phallic object which can be used for sexual pleasure.A small number of Acrotomophiles may enjoy the idea of dominating the amputee during couples play and they may also become aroused with the thought of having to take care of an amputee.

Acrotomophilia (from the Greek ἀκρότομος "having the top cut off" (from ἄκρον "akron" "extremity" and -τομος "-tomos" from τέμνω "temno" "I cut") and φιλία "philia" "love") is a paraphilia in which an individual expresses strong sexual interest in amputees. It is a counterpart to "apotemnophilia", the sexual interest in "being" an amputee.

Hand fetishism or hand partialism or also Quirofilia is the sexual fetish for hands. This may include the sexual attraction to a specific area such as the fingers, palm or nails, or the attraction to a specific action performed by the hands; which may otherwise be considered non-sexual—such as washing or drying dishes. This fetish may manifest itself as a desire to experience physical interaction, or as a source of sexual fantasy.

Hand fetishism is recognized by the porn industry; however, it is one of the least common fetishes, despite foot fetishism being the most common.

Hand fetishism is usually based in the biological indication that a partner is healthy and a good potential mate.

In 2007, a study was conducted by the University of Bologna on around 5000 fetishist participants to see the prevalence of fetishes. The study analyzed the content inside online fetish communities and found only 669 participants referring to nails, an extension of hand fetishism. This did not refer to fingernails specifically, and the amount of 669 was less than 1% of the participants.

In order to determine the relative prevalences of different types of fetishes, scientists obtained a sample of at least 5000 individuals worldwide from 381 Internet discussion groups. The relative prevalences were estimated based on (a) the number of groups devoted to a particular fetish, (b) the number of individuals participating in the groups and (c) the number of messages exchanged. Using these measures, feet and shoes were found to be the most common target of preferences. This is consistent with an analysis of millions of search queries by users from the USA that were accidentally released during the AOL search data scandal. Sixty-four (64) percent of the sampled population that had a preference for an object associated with the body had a preference for shoes, boots, and other footwear.

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.

Macrophilia is a fascination with or a sexual fantasy involving giants, more commonly expressed as giantesses (female giants). It is typically a male fantasy, with the male playing the "smaller" part—entering, being dominated, or being eaten by the larger woman. Others involve partners who naturally have a significant difference in size.

Although macrophilia literally translates to simply a "lover of large," in the context of a sexual fantasy, it is used to mean someone who is attracted to beings larger than themselves. Generally, the interest differs between people, and depends on gender and sexual orientation. They often enjoy feeling small and being abused, degraded, dominated, or eaten, and they may also view female giants as being powerful and dominating.

Commenting on why there are not as many female macrophiles, psychologist Helen Friedman theorized that because women in most societies already view men as dominant and powerful, there is no need for them to fantasize about it. Women that take on the roles of the giantess within this fetish often find the practice to be empowering and enjoy being worshipped.

The roots of macrophilia may lie in sexual arousal in childhood and early adolescence which is accidentally associated with giants, according to Dr. Mark Griffiths's speculation.

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.

Diaper fetishists and diaper lovers (DLs) are often associated with adult babies, as both wear diapers, but the former do not engage in childlike behavior, while that is the distinguishing characteristic of adult babies (ABs). The majority of diaper lovers do not engage in any kind of infantile activity and are only interested in diapers. However, in certain individuals it is possible for an overlap to occur, as one can view themselves as neither exclusively an adult baby nor a diaper lover. Hence adult babies and diaper lovers collectively refer to themselves as AB/DLs. Diapers and rubber pants with "baby" prints are sold in adult sizes.

Boot fetishism is a sexual fetish focused on boots. Boots have become the object of sexual attraction amounting to fetishism for some people and they have become a standard accessory in BDSM scenes (where leather, latex and PVC boots are favoured) and a fashion accessory in music videos. Boots are seen as perhaps the most fetishistic of all footwear and boots may be the most popular fetish clothing attire.

Salirophilia is a sexual fetish or paraphilia that involves deriving erotic pleasure from soiling or disheveling the object of one's desire, usually an attractive person. It may involve tearing or damaging their clothing, covering them in mud or filth, or messing their hair or makeup. The fetish does not involve harming or injuring the subject, only their appearance.

It is related to wet and messy fetishism, bukkake, omorashi, mysophilia, urolagnia and coprophilia, but extends to other areas such as forcing the partner to wear torn or poorly fitting clothing and other actions which would render them normally unattractive.

The fetish sometimes manifests itself in the defacing of statues or pictures of attractive people, especially celebrities or fictional characters. It is common to refer to the practice involving ejaculating on a photo as "facepainting". The fetishist finds this sexually exciting, rather than mere vandalism. They sometimes form collections of defaced art for future enjoyment. A video of the fetishist ejaculating on a picture of someone or a photo depicting the result is known colloquially as a "tribute".

The term comes from the French for soiling, "salir". In cases where the fetish is obsessive it is called saliromania. It is frequently confused with salophilia, an attraction to salt or salty things (especially body sweat) that derives from the Latin for salt, "sal".

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.

Foot fetishism has been defined as a pronounced sexual interest in feet. Extensions of this fetish include shoes and tickling. Sigmund Freud considered foot binding as a form of fetishism. For a foot fetishist, points of attraction include the shape and size of feet and toes (e.g., long toes, short toes, painted toenails, high arches, soles etc.), jewelry (e.g., toe rings, anklets, etc.), treatments (such as massaging, washing partner's feet or painting partner's toenails), state of dress (barefoot, flip flops, sandals, high heels, hosiery, socked feet, etc.), odor and/or sensory interaction (e.g., rubbing the foot, tickling, smelling, kissing, biting, licking, sucking toes, rubbing genitals on foot, etc.).

As a paraphilia, breast fetishism (also known as mastofact, breast partialism, or mazophilia) is a highly atypical sexual interest focused on female breasts (see partialism). The term "breast fetishism" is also used in the non-paraphilic sense, to refer to cultural attention to female breasts and the sexuality they represent, with debate existing as to whether the modern widespread fascination with breasts among heterosexual males in western societies is a sexual fetish.