The 22-year-old posed naked for the magazine's cover shot, covered in mud, while hugging her pet pig Bubba Sue from behind.
The Wrecking Ball singer now describes herself as gender fluid, and says she's open to "every single thing that is consenting and doesn't involve an animal."
"Everything that's legal, I'm down with," she said.
"Yo, I'm down with any adult - anyone over the age of 18 who is down to love me.
"I don't relate to being boy or girl, and I don't have to have my partner relate to boy or girl."
Read more:
• Miley Cyrus goes full frontal for Paper magazine
• Watch Miley Cyrus and Ariana Grande cover a Crowded House classic
Last month Cyrus founded the Happy Hippie Foundation to raise funds and awareness for homeless and LGBT youth.
"I can't drive by in my f***ing Porsche and not f***ing do something," she said.
"I see it all day: people in their Bentleys and their Rolls and their Ubers, driving past these vets who have fought for our country, or these young women who have been raped."
- AAP