The pornography site Pornhub's 2015 annual report showed that compared to 2014, the biggest increase in search topic was giantess, which had a 1091 percent gain in searches.

The internet has played an important role in helping to develop the fetish. Women who take on the roles of the giantess within this fetish often find the practice to be empowering and enjoy being worshipped. Speculating on why there are not as many female macrophiles, psychologist Helen Friedman theorized that women who already view men as dominant and powerful have no need to fantasize about it. Psychologist Mark Griffiths speculates that the roots of macrophilia may lie in sexual arousal in childhood and early adolescence that is accidentally associated with giants.

Macrophiles often enjoy feeling small and being abused, degraded, dominated, or eaten, and they often view the much taller being as powerful and dominating. Generally, the interest differs between macrophiles, and depends on gender and sexual orientation. Although macrophilia literally translates to simply a 'lover of large,' in the context of a sexual fantasy, it is used to denote attraction to beings larger than themselves.