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Michael A. Perelman, Ph.D.

Founder & Chairman

MAP Education & Research Foundation

New York, N.Y. USA

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Co-Director, Human Sexuality Program�Clinical Professor Emeritus of Psychology in Psychiatry�Former Clinical Professor of Reproductive Medicine & Urology�Weill Cornell Medicine | NewYork-Presbyterian

Fundamentals of Sexual Medicine

for Mental Health Professionals

2025 SMSNA Fall Scientific Meeting

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��

Adapted from Rosen, CIEF

Sexual response is best understood as an endpoint, representing the cumulative interaction of every “Mental” (cognitive, behavioral, social and cultural factor,

AND the “Physical” or biomedical ones.

False Dichotomy: Organic vs Psychogenic

Biopsychosocial: It Is Always Mental And Physical

Engel, 1977; Perelman, 2024

George Engel, 1913 – 1999

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�Re-Examining How You Apply �The Biopsychosocial Model

Most sex therapy practitioners and sexual medicine physicians pay lip service to using the biopsychosocial approach for diagnosis and treatment.

However, it is my observation after 50 years in this field,

that each group tends to focus on one or two aspects

of the model overly exclusively, with insufficient awareness/attention to other contributing factors.

Re-examining one’s approach will remind clinicians of criteria they are using productively, but also alert them to “blind spots” resulting from specialized training cultivated within their professions of origin

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Re-Examining How You Apply �The Biopsychosocial Model

However, it’s not just the therapists of course, who are biased at times, as most physicians do not truly attend to the cognitive, emotional, behavioral, and cultural factors contributing to or exacerbating a sexual disorder?

Few physicians, when prescribing medications to improve s sexual function inquire of the patient (or their partner)

if the patient’s goals for sexual activity are aligned with those of their partner?

Even for those physicians who might prefer broader in-depth assessment, the time limitations of most physician and even specialist’s office visits typically negate the potential for multilayered engagement.

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Re-Examining How You Apply �The Biopsychosocial Model

During the much of the 20^th century psychosocial factors were given great prominence, first by psychoanalysts and later by sex therapists who typically were mental health professionals.

Yet it seems to me, that too many mental health professionals still fail to sufficiently attend to the biomedical aspects of a patient’s complaint, both in terms of � understanding etiology and in planning treatment; despite a stated allegiance to a biopsychosocial model. �

Perelman, 2014

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Fundamentals of Sexual Medicine �for Mental Health Professionals

This workshop is designed to assist workshop is designed to help mental health professionals avoid that bias and to enhance their ability to successfully collaborate with sexual medicine physicians in the care of their mutual patients.

While no one expects a single workshop to make Master Clinicians, our distinguished panel will share their approaches in a manner which will facilitate your communication and collaboration with your sexual medicine colleagues

Future programs are planned to provide reciprocal exposure for sexual medicine physicians.

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Fundamentals of Sexual Medicine �for Mental Health Professionals

.The biopsychosocial model must encompass all predisposing, precipitating, and maintaining biological, medical/surgical, cognitive, behavioral, emotional, social, and cultural factors involved in the etiology and management of sexual disorders. Etiology is best understood at a granular level that acknowledges multiple proportional contributing factors. We recommend that clinicians across disciplines increase their awareness of all relevant etiologic and treatment factors while continuing to use the accessible term “biopsychosocial.”

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