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.

Psychosexual disorders can vary greatly in severity and treatability. Medical professionals and licensed therapists are necessary in diagnosis and treatment plans. Treatment can vary from therapy to prescription medication. Sex therapy, behavioral therapy, and group therapy may be helpful to those suffering distress from sexual dysfunction. More serious sexual perversions may be treated with androgen blockers or selective serotonin reuptake inhibitors (SSRIs) to help restore hormonal and neurochemical balances.

In order to determine the relative prevalence of different fetishes, scientists obtained a sample of at least 5000 individuals worldwide, in 2007, 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. Of the sampled population, 7 percent were sexually aroused by hair (as opposed to 12 for underwear, but only 4 for genitals, 3 for breasts, 2 for buttocks, and less than one for body hair).

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).

Hair fetishism, also known as hair partialism and trichophilia, is a partialism in which a person sees hair most commonly, head hair as particularly erotic and sexually arousing. Arousal may occur from seeing or touching hair, whether head hair, pubic hair, axillary hair, chest hair or fur. Head-hair arousal may come from seeing or touching very long or short hair, wet hair, certain colors of hair or a particular hairstyle. Pubic hair fetishism is a particular form of hair fetishism.

Haircut fetishism is a related paraphilia in which a person is aroused by having their head hair cut or shaved, by cutting the hair of another, by watching someone get a haircut, or by seeing someone with a shaved head or very short hair.

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.

In the DSM-5 all paraphilia disorders can be diagnosed by two main criteria that are referred to criteria A and criteria B respectively. The A and B criteria include a duration in which the behavior must be present for (typically 6 months) and specific details of actions or thoughts that are correlated specifically with the respective disorder being diagnosed.

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.

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.

Transvestism is the practice of dressing and acting in a style or manner traditionally associated with the opposite sex. In some cultures, transvestism is practiced for religious, traditional or ceremonial reasons.

Armpit fetishism (also known as "maschalagnia") is a partialism in which an individual is sexually attracted to armpits - something which may lead to axillism, or armpit intercourse (sexual activity with one or both armpits).

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.

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.

Patients may be ashamed or actively attempt to disguise their symptoms. This can make diagnosis difficult as symptoms are not always immediately obvious, or have been deliberately hidden to avoid disclosure. If the patient admits to hair pulling, diagnosis is not difficult; if patients deny hair pulling, a differential diagnosis must be pursued. The differential diagnosis will include evaluation for alopecia areata, iron deficiency, hypothyroidism, tinea capitis, traction alopecia, alopecia mucinosa, thallium poisoning, and loose anagen syndrome. In trichotillomania, a hair pull test is negative.

A biopsy can be performed and may be helpful; it reveals traumatized hair follicles with perifollicular hemorrhage, fragmented hair in the dermis, empty follicles, and deformed hair shafts (trichomalacia). Multiple catagen hairs are typically seen. An alternative technique to biopsy, particularly for children, is to shave a part of the involved area and observe for regrowth of normal hairs.

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.

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.

The natural body smell is a powerful force in sexual attraction, and can be focused by the strong pungent odor of the armpit: Alex Comfort considered that for a woman to shave her armpits was “simply ignorant vandalism”, obliterating a powerful sexual tool, and praised the French for greater sexual awareness than American deodorant culture in this regard.

A woman's armpits, armpit hair, and secretions can be seen as essential components of her femininity, whether this is positively or negatively valued. Havelock Ellis found evidence that (in a non-sexual context) smelling one's own armpit could act as a temporary energy boost.

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.

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.

Transvestic fetishism is a psychiatric diagnosis applied to those who are thought to have an excessive sexual or erotic interest in cross-dressing; this interest is often expressed in autoerotic behavior. It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal, and is categorized as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association. (Sexual arousal in response to donning sex-typical clothing is homeovestism.)

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.

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.

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.

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.