Understanding Sexual Balance: Latest Update To The STP Model.

The STP illustrates an expanded Biopsychosocial variable control model.

The Sexual Tipping Point® model illustrates whether a person is “turned on or turned off,” with the simultaneous capability of depicting all the complex multifaceted factors intrinsic to understanding any sexual response. 

The Sexual Tipping Point® or STP depicts the moment to moment interaction of a person’s constitutional sexual capacity with the biomedical- psychosocial and cultural factors that determine sexual their response.

A person’s STP differs from one experience to another, based on the proportional impact of one factor dominating, as others recede in importance. The STP model can illustrate both the intra and inter-individual variability characterizing sexual response and its disorders for both men and women.

Previously, the STP was labeled as one of a number of “Dual Control” models. Instead, it should be thought of as a “variable control” biomedical-psychosocial and cultural model. The STP is easily used to explain etiology and highlight treatment targets for patients. It helps healthcare clinicians disabuse patients of erroneous binary beliefs. Clinicians can then instill hope through a simple explanation of how the problem’s causes can be diagnosed, parsed, and fixed.

The latest drawing of the Sexual Tipping Point® model is shown below illustrating a person who is "at rest" with their mind and body, mental and physical factors that determine their sexual response(s) balanced in a neutral position.

An STP Model explanation is found at mapedfund.org. Factors slide along the axes to indicate their polarity and valence.Source: Used with permission of the MAP Education and Research Foundation a 501 (c)(3) public charity.

An STP Model explanation is found at mapedfund.org. Factors slide along the axes to indicate their polarity and valence.

Source: Used with permission of the MAP Education and Research Foundation a 501 (c)(3) public charity.

The following description will familiarize you with the STP model's graphic representations and its fundamental elements.

Two “arms” on a balance scale labeled “Excitation” and “Inhibition” hold all the known and unknown exciting (+) and inhibiting (-) billions of factors that dynamically influence a sex-positive or sex-negative response.

Each factor is represented by a “slider (O)” with progressively deepening hues of red representing, increasing excitation, and blue for increasing sexual inhibition. Factors that influence a person at a specific moment in time are chosen from the matrix below the balance beam where the most common factors are listed.


The depth of hue color for each factor/slider (O) changes as it shifts along its axis based on the variable polarity strength and valence that factor contributes to the person’s sexual response. Besides color, each factor/slider (O) is lettered within the matrix with an “M” or “P” indicating whether it is a Mental or Physical factor.

The dots separating the mental from physical sides of the matrix reflect the continuous interaction of the mind and body (mental and physical) based on the bidirectional process of thoughts translating into biochemical/electrical components and vice versa.

Each slider (O) is also numbered to identify which of the most common factors it represents when placed into the arms of the balance beam.

Since culture is manifested within many of the domains of the listed factors, it is not depicted with its own unique factor axis. Some additional factors may be neutral (=) and others are not yet discovered (?). The STP is the net sum of all Mental and Physical factors, displayed on a balance scale spanning excitation to inhibition (or Hot to Not).

So, each factor's “slider” setting contributes to the STP’s dynamic representation of an individual’s manifest sexual response at any moment in time.


References

Perelman, MA (2009) The sexual tipping point: a mind/body model for sexual medicine. J. Of Sexual Medicine, 6 (3), 227–632.

Perelman, M. A. (2018). Sex Coaching for Non-Sexologist Physicians: How to Use the Sexual Tipping Point Model, 15(12), 1667–1672.

Perelman, M. A. (2016). Introduction: Advocating for a Transdisciplinary Approach to the Management of Sexual Disorders. In L. I. Lipshultz, A. W. Pastuszak, A. Giraldi, A. T. Goldstein, & M. A. Perelman (Eds.), Management of Sexual Dysfunction in Men and Women(pp. 1–8). New York, NY: Springer New York. 

Perelman, M. A. (2018). Why the Sexual Tipping Point® Is a “Variable Switch Model.” Current Sexual Health Reports, 6(2), 1–6. 

Perelman, M. A. (2009). The sexual tipping point: a mind/body model for sexual medicine. Journal of Sexual Medicine, 6(3), 227–632. 


/Source

Michael Perelman

MICHAEL A. PERELMAN, Ph.D.

Michael@mapedfund.org

Dr. Michael A. Perelman is a Clinical Professor Emeritus of Psychiatry and former Clinical Professor of Reproductive Medicine, and Urology at Weill Cornell Medicine in NYC.  He has directed its Human Sexuality Program, for over 30 years. That program is the longest running sex therapy case conference in the world, providing continuing education for its graduates and guests.  A National Institute of Health Fellow, in 1976 he wrote the first sex therapy dissertation in Columbia’s history. Dr. Perelman was Chief Intern at Duke University Medical Center, followed by a Post-Doctoral Fellowship studying sex therapy with Helen S. Kaplan at NY Presbyterian Hospital.

 

In 2012 he founded the MAP Education and Research Foundation a 501(c) (3) public charity, that emphasizes a biomedical-psychosocial and cultural approach to the diagnosis and treatment of sexual disorders, using its Sexual Tipping Point® Model. The Foundation grants STP Awards for best abstract/presentations delivered at sexual health care professional meetings.

 

As an international leader and member of over 25 professional associations, Dr. Perelman served on several of their boards of directors and was the President of The Society for Sex Therapy and Research (SSTAR).  He was elected a Fellow to the Sexual Medicine Society of North America (SMSNA), the Society for the Scientific Study of Sex (SSSS), , and the International Society for Study of Women’s Sexual Health (ISSWSH).  He was appointed to the Sexual Function Advisory Council of the American Urological Association (AUA), the Standards Committee of the International Society for Sexual Medicine (ISSM), and both the American Psychiatric Association’s DSM-V and DSM 5TR Task Force as an Advisor to the Sex/GID Work Group.

 

In 2015, the Society for Family Psychology of the American Psychological Association (APA) presented him with their Award for Excellence in Teaching. The American Association of Sex Educators, Counselors, and Therapists (AASECT) certifies him as a sex therapy diplomate, supervisor, sex educator, sex counselor, and honored him with their 2012 Award for Professional Standard of Excellence and their 2019, Integrative Sex Therapy Award. In 2021 the University of Minnesota Medical School’s Department of Family Medicine and Community Health’s Program in Human Sexuality selected him as a “Distinguished Sexual and Gender Health Revolutionary.” In 2022, the SMSNA presented him with a Lifetime Achievement Award at the combined Sexual Medicine Society of North America/International Society for Sexual Medicine (SMSNA/ISSM). In 2025, he was named, “Honorary Member” of the International Society for Study of Women’s Sexual Health (ISSWSH). In 2026 ISSWSH presented him with their Lifetime Achievement Award, and he also received the Society for Health Psychology (APA Division 38), 2026 Excellence in Clinical  Health Psychology Award.

           

His co-edited, Management Of Sexual Dysfunction In Men And Women: An Integrated Approach, was published in 2016. In 2012 he became the Editor in Chief, for Springer’s Current Sexual Health Reports, and now is Emeritus Editor in Chief. He serves on several publications’ Board of Directors as a consulting editor, or as a reviewer. He has published over 70 peer reviewed articles, countless abstracts, posters, and over 25 chapters in sexual medicine texts, along with over 300 invited presentations.  His invited Blog for Psychology Today is called the “Sexual Tipping Point.” Dr. Perelman maintains an independent sex and couples’ therapy practice in both Greenwich, CT and Manhattan. He is certified by NYS and listed in the National Register of Health Service Providers in Psychology. Dr. Perelman has conducted clinical trials, served on dozens of industry advisory boards and speakers’ bureaus, as well as providing expert witness consultations.  His work in sex and marital therapy is often featured in the media.