Both straight and gay individuals fist. In straight couples who express a high degree of sexual liberation, vaginal or anal fisting occurs. A male may fist a female, or a female may fist a male. Open-minded gay couples may engage in anal fisting or front hole fisting if a partner is trans. Lesbian couples may fist anally or vaginally (or in the front hole if trans).

In the gay fisting community, there is a high degree of neurodivergent fisters.

Most gay fisters do not identify as sadists or masochists and do not consider themselves dom or sub. Most fisters do not consider fisting as a BDSM activity.

There are several categories and expressions of fisting. Category refers to the core activity and expression refers to specific qualifiers in that activity.

Fisting generally requires some preparation by both partners, so it is often less spontaneous than traditional sex. In most circumstances, this specifically means that a bottom must prepare lube and complete an advanced clean-out, and a top must have trimmed and filed his nails and washed his hands/arms.

It is not uncommon for fisting to be coupled with traditional sex.

Fisting can occur almost anywhere. Due to anatomical restrictions, most fisters play on beds/mattresses or in slings; however, advanced bottoms can take fists while standing erect.

Outside of private residences, fisting has been observed at bars and clubs, organized fisting events at hotels and public venues, in cruising parks and natural areas, and even on a street corner in broad daylight at fetish events such as Dore Alley.

Regular fisters almost universally report that the orgasms are overwhelming, the intimacy is unmatched, and the sense of fraternity/community is incredibly strong. Trust/fraternity, intimacy, communication, self-mastery, comfort, and serenity are core, foundational concepts of fisting. Fisters that neglect these concepts often struggle with taking and giving fists.