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An endless array of bridles, saddles, tack, anal dildos with tails, "hooves" that attach like gloves and boots, and related items are produced and sold commercially to those who wish to act out such fantasies.
Ponygirl play is sometimes considered a bondage game or BDSM practice. This is not always the case, however; like almost any other sexual game, it can be acted out by itself or in conjunction with other sexual elements.
While there are a few men who have "ponyboy" fantasies, the "human pony" is a form of sexual play primarily of interest to women. That said, ponygirls occasionally appear in the photography in sexual literature marketed to men.