Califia, assigned female at birth, was born into a Mormon family. He came out as a lesbian in 1971 in Salt Lake City, Utah, and changed his name to Pat Califia, taking the surname Califia after the mythical Amazon. After getting involved in consciousness-raising work in the area, he bought a one-way ticket to San Francisco in 1973, bringing an interest in sex education to work on the San Francisco Sex Information switchboard.

His first book was Sapphistry, a non-fiction work which described butch-femme sexuality and BDSM safety and practice in a non-judgmental tone. Subsequently, he published work in lesbian, gay and feminist magazines, including a long-running sex advice column in The Advocate. In 1979, as a student in psychology at San Francisco State University, his research was published in the Journal of Homosexuality.

With the founding of SAMOIS, Califia shifted focus to the lesbian experience of BDSM and made a major contribution to the diversification of the leather subculture. He contributed to the book Coming to Power published by Alyson Publications. Another book, the Lesbian Sadomasochism Safety Manual won the 1990 Bookseller/Diagram Prize for Oddest Title of the Year. Califia founded the leatherwomen's quarterly Venus Infers in 1992, and in 1996 was co-editor (with Robin Sweeney) of A Leatherdyke Reader, a sequel to Coming to Power.

During this period Califia was both writing about queer studies and gender identity and coming to terms with these issues on a personal level. During the mid-1990s, Califia decided to transition, adopting the name of Patrick.

Since the 1990s, Califia has had fibromyalgia, which has reduced his ability to type or write. He is currently in private practice as a therapist (he is a licensed marriage therapist and family therapist in the state of California). He continues to publish his work and attend leather community events.

Califia's most recent book is Boy in the Middle, a collection of erotic stories. He is currently working on a number of other projects including a book on FTM sexuality.

His pornographic works were often seized by Canadian customs until he fought a court case to allow them to be accepted. Afterwards he wrote of his amusement at finding that anti-porn feminist Catherine Itzin's book Pornography: Women, Violence and Civil Liberties was seized under the very law she had helped to establish, while Califia's books were recognised as acceptable by that law. Califia fought against anti-pornography legislation co-authored by Catharine MacKinnon.

Non-fiction

• What Color is Your Handkerchief: A Lesbian S/M Sexuality Reader (ed), SAMOIS, 1979.
• Pat Califia: "A Personal View of the History of the Lesbian S/M Community and Movement in San Francisco", 1981. in: Coming to Power: Writings and Graphics on Lesbian S/M. Alyson Publications, Boston, 3rd ed Oktober 1987, ISBN 0-932870-28-7
• Sapphistry: The book of lesbian sexuality, Naiad Press, April 1988, ISBN 0-941483-24-X
• Lesbian Sadomasochism Safety Manual, Alyson Books, June 1988, ISBN 1-555833-01-2
• Advocate Adviser, Alyson Books, June 1991, ISBN 1-55583-169-9
• Forbidden Passages: Writings Banned in Canada, Cleis Press, November 1995, ISBN 1-57344-019-1
• Sex Changes: The Politics of Transgenderism, Cleis Press, July 1997, ISBN 1-57344-072-8
• Sensuous Magic: A Guide for Adventurous Lovers, Masquerade Books, January 1998, ISBN 1-56333-610-3
• Bitch Goddess: The Spiritual Path of the Dominant Woman, Greenery Press, December 1998, ISBN 1-890159-04-2
• Public Sex: The Culture of Radical Sex , Cleis Press, June 2000, ISBN 1-57344-096-5
• Speaking Sex to Power: The Politics of Queer Sex, Cleis Press, November 2001, ISBN 1-57344-132-5

Fiction

• Macho Sluts, Alyson Publications, November 1988, ISBN 1-55583-115-X
• Doing It for Daddy: Short Sexy Fiction About a Very Forbidden Fantasy, Alyson Publications, December 1994, ISBN 1-55583-227-X
• Doc and Fluff: The Dystopian Tale of a Girl and Her Biker, Alyson Publications, May 1996, ISBN 1-55583-369-1
• The Second Coming: A Leatherdyke Reader, Alyson Publications, July 1996, ISBN 1-55583-281-4
• Melting Point: A Collection of Erotic Short Stories, Alyson Publications, November 1996, ISBN 1-55583-380-2
• Diesel Fuel: Passionate Poetry, Masquerade Books, May 1997, ISBN 1-56333-535-2