SEXUAL TIPPING POINT MODEL REFERENCES AND CITATIONS IN THE LITERATURE:
FAQ: What is the citation that should be used if I incorporate any of the STP or mapedfund images into my own presentation or use in my own publications? "This image is provided courtesy of Michael A. Perelman, Ph.D. and is based on the Sexual Tipping Point Model®, owned by and used with the permission of the MAP Education & Research Foundation (mapedfund.org).”
Sexual Tipping Point® Model — Publications by Michael A. Perelman
MAP Education & Research Foundation · Compiled 8 August 2026. Reverse chronological. Reference style follows the Journal of Sexual Medicine (Oxford University Press).
2026
1. Perelman MA. “Toward a biopsychosocial tipping point framework: insights from sexual medicine.” Sex Med Rev. 2026;14(2).
2025
2. Perelman MA, Giraldi A, Parish S, Wittmann D, Fisher W, Bober SL, Pastuszak A, Pfaus J. “How has the biopsychosocial model fared in sexual medicine and sex therapy?” Sex Med Rev. 2025;13(4):663–673. doi:10.1093/sxmrev/qeaf029. Article qeaf029.
3. Perelman MA, Giraldi A, Parish SJ, Wittmann D, Fisher W, Bober S, Pastuszak A, Pfaus J. “(078) How has the biopsychosocial model fared in sexual medicine/sexual therapy and recommendations for the future.” J Sex Med. 2025;22(suppl 1):qdaf068.071. doi:10.1093/jsxmed/qdaf068.071
2024
4. Perelman MA. “(356) Reframing the bio-psychosocial model for sexual medicine.” J Sex Med. 2024;21(suppl1):qdae001.341. doi:10.1093/jsxmed/qdae001.341
2023
5. Perelman MA. “(492) The Sexual Tipping Point®: why we should employ a ‘biomedical-psychosocial & cultural model’ versus the current ‘bio-psychosocial’ one.” J Sex Med. 2023;20(suppl 1):qdad060.464. doi:10.1093/jsxmed/qdad060.464
6. Perelman MA. “Comment on ‘Similarities and differences between men with self-reported lifelong and acquired difficulty reaching orgasm.’” Int J Impot Res. 2023. doi:10.1038/s41443-023-00769-3
2022
7. Perelman MA. “The Sexual Tipping Point®: why we should employ a ‘biomedical-psychosocial & cultural model’ versus the current ‘bio-psychosocial’ one.” Poster #492 presented at the Joint Fall Scientific Meeting of the Sexual Medicine Society of North America and the International Society for Sexual Medicine, Miami, FL; October 2022.
2021
8. Perelman MA. “The Sexual Tipping Point®: a biomedical-psychosocial & cultural model.” In: Nobre P, et al, eds. Encyclopedia of Sexuality and Gender. Cham: Springer International Publishing; 2021.
9. Perelman MA. “Understanding, diagnosing and treating delayed ejaculation using the Sexual Tipping Point model.” In: Nobre P, et al, eds. Encyclopedia of Sexuality and Gender. Cham: Springer International Publishing; 2021.
2018
10. Perelman MA. “Sex coaching for non-sexologist physicians: how to use the Sexual Tipping Point model.” J Sex Med. 2018;15(12):1667–1672. doi:10.1016/j.jsxm.2018.10.010
11. Perelman MA. “Why the Sexual Tipping Point® is a ‘variable switch model.’” Curr Sex Health Rep. 2018;10(2):38–43. doi:10.1007/s11930-018-0148-3
2017
12. Perelman MA. “Sexual Tipping Point® model in couple and family therapy.” In: Lebow JL, Chambers AL, Breunlin DC, eds. Encyclopedia of Couple and Family Therapy. Cham: Springer International Publishing; 2017:1–11. doi:10.1007/978-3-319-15877-8_709-1
13. Perelman MA. “Delayed ejaculation in couple and family therapy.” In: Lebow JL, Chambers AL, Breunlin DC, eds. Encyclopedia of Couple and Family Therapy. Cham: Springer International Publishing; 2017:1–6. doi:10.1007/978-3-319-15877-8_456-1
14. Perelman MA. Understanding Sexual Balance: A Key to the Sexual Tipping Point Model. New York, NY: MAP Education & Research Fund; 2017.
2016
15. Perelman MA. “Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model.” Transl Androl Urol. 2016;5(4):563–575. doi:10.21037/tau.2016.07.05
16. Perelman MA. “Why the Sexual Tipping Point® model?” Curr Sex Health Rep. 2016;8(1):39–46. doi:10.1007/s11930-016-0066-1
17. Perelman MA. “Reexamining the definitions of PE and DE.” J Sex Marital Ther. 2017;43(7):633–644. doi:10.1080/0092623X.2016.1230161
18. Perelman MA. “Introduction: advocating for transdisciplinary treatment of sexual dysfunction employing a biopsychosocial-behavioral & cultural approach.” In: Lipshultz LI, Pastuszak AW, Giraldi A, Goldstein AT, Perelman MA, eds. Management of Sexual Dysfunction in Men and Women: An Interdisciplinary Approach. New York, NY: Springer; 2016:1–8. doi:10.1007/978-1-4939-3100-2_1
19. Perelman MA, Watter DN. “Psychological aspects of erectile dysfunction.” In: Kohler TS, McVary KT, eds. Contemporary Treatment of Erectile Dysfunction: A Clinical Guide. 2nd ed. Cham: Springer International Publishing; 2016:29–43. doi:10.1007/978-3-319-31587-4_3
2014
20. Perelman MA. “The history of sexual medicine.” In: Diamond L, Tolman D, eds. APA Handbook of Sexuality and Psychology, Vol 2: Contextual Approaches. Washington, DC: American Psychological Association; 2014:137–179. doi:10.1037/14194-005
2013
21. Perelman MA, Grill EA. “Role of sex therapy for male infertility.” In: Goldstein M, Schlegel PN, eds. Male Infertility: Surgical and Medical Management. New York, NY: Cambridge University Press; 2013:204–218.
2012
22. Perelman MA. “Sexual balance: the universal versatility of the Sexual Tipping Point model.” J Sex Med. 2012;9(suppl 4):266.
23. Perelman MA. “Helen Singer Kaplan’s legacy and the future of sexual medicine.” J Sex Med. 2012;9(suppl 4):227.
2011
24. Perelman MA. “The Sexual Tipping Point®: a mind/body model for the past, present, and future.” J Sex Med. 2011;8(suppl 3):84–299.
2009
25. Perelman MA. “The Sexual Tipping Point®: a mind/body model for sexual medicine.” J Sex Med. 2009;6(3):629–632. doi:10.1111/j.1743-6109.2008.01177.x
26. Perelman MA. “Integrated sex therapy: a psychosocial-cultural perspective integrating behavioral, cognitive, and medical approaches.” In: Carson CC, Kirby RS, Goldstein I, Wyllie MG, eds. Textbook of Erectile Dysfunction. 2nd ed. London: Informa Healthcare; 2009:298–305.
2007
27. Perelman MA. “Clinical application of CNS-acting agents in FSD.” J Sex Med. 2007;4(suppl 4):280–290. doi:10.1111/j.1743-6109.2007.00611.x
28. Perelman MA. “The impact of relationship variables on the etiology, diagnosis and treatment of erectile dysfunction.” Adv Prim Care Med Clin Update. 2007;3:3–6.
29. Perelman MA. “‘Dial it up, dial it down’: why combination therapy for PE?” Poster presented at the Annual Meeting of the Society for Sex Therapy and Research, Atlanta, GA; March 2007.
2006
30. Perelman MA. “Psychosocial aspects related to erectile dysfunction.” In: Mulcahy JJ, ed. Male Sexual Function: A Guide to Clinical Management. Totowa, NJ: Humana Press; 2006.
31. Perelman MA, Rowland DL. “Retarded ejaculation.” World J Urol. 2006;24(6):645–652. doi:10.1007/s00345-006-0127-6
32. Perelman MA. “A new combination treatment for premature ejaculation: a sex therapist’s perspective.” J Sex Med. 2006;3(6):1004–1012.
33. Perelman MA. “The Sexual Tipping Point™: a model to conceptualize etiology, diagnosis & combination treatment of female & male sexual dysfunction.” Abstract #121. J Sex Med. 2006;3(suppl 1):52.
34. Perelman MA. “The ‘ejaculatory tipping point’: a model for the etiology, diagnosis, and treatment of delayed/retarded ejaculation.” Round Table 3.3. J Sex Med. 2006;3(suppl 5):358.
35. Perelman MA. “The multidimensional etiology of premature ejaculation.” Round Table 3.1. J Sex Med. 2006;3(suppl 5):356.
36. Perelman MA. “Why combination treatment for premature ejaculation?” Abstract PP-04-251. J Sex Med. 2006;3(suppl 5):80. Book of Abstracts, 9th Congress of the European Society for Sexual Medicine, Vienna
37. Perelman MA. “Unveiling retarded ejaculation.” Abstract #1337. J Urol. 2006;175(4 suppl):430.
Sexual Tipping Point® Model — Citations in the Literature by Other Authors
MAP Education & Research Foundation · Compiled 8 August 2026
Scope: published works by other authors that reference the Sexual Tipping Point® model, including works on which Dr. Perelman is a co-author but not first author.
Reverse chronological. Reference style follows the Journal of Sexual Medicine (Oxford University Press).
2026
1. Herder T, Knegtering H, Boonstra N, Spoelstra SK. “Beyond medication: a biopsychosocial-existential framework for sexual dysfunction in psychiatry.” J Sex Med. 2026;23(9):qdag241. doi:10.1093/jsxmed/qdag241
2. Shimizu JPK, Dawson SJ, Fitzpatrick ET, Tavares IM, Kempster O, Rosen NO. “Supporting the transition to parenthood through Online Sex and Relationship Knowledge (STORK): a mixed methods feasibility pilot study among sexual and gender/sex diverse new parents.” LGBTQ+ Family. 2026. doi:10.1080/27703371.2026.2635395
3. Sansone A, Mantegazza R, Ohri Vignesh S, Jannini EA. “Narrative-based sexual medicine: a collection of patients’ stories and clinical cases to better understand the management of erectile dysfunction with type 5 phosphodiesterase inhibitors in real life.” Aging Male. 2026;29(1):2652123. doi:10.1080/13685538.2026.2652123
4. Parish SJ, Kling JM, Coleman E, […], Reisman Y. “Update on curriculum standards for sexual health education, impact, and platforms for medical training: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).” Sex Med Rev. 2026;14(3):qeag030. doi:10.1093/sxmrev/qeag030
5. La Pera G, et al. “Balancing clinical and social approaches to sexual health: an integrative view of the Porto Protocol.” J Sex Med. 2026.
6. El Kak F, Giraldi A. “Sexual health framing sexual medicine: toward a more humanistic framework.” Invited editorial. Sex Med Rev. 2026;14(2).
7. Sánchez-Pérez GM, Sierra JC. “Associations between solitary masturbation parameters and sexual arousal in partnered sexual activity.” Behav Sci (Basel). 2026.
8. Waki M, Imai S. “Clinical characteristics and outcomes of masturbation aid–based retraining for intravaginal ejaculatory difficulty.” J Sex Med. 2026.
9. Shin D, Sansone A, Krishnappa P, […], Shah R. “Sexual dysfunctions in male patients with infertility: recommendations from the Fifth International Consultation on Sexual Medicine.” Sex Med Rev. 2026.
2025
10. Kaplan M, Uçar M, Yiğit MF. “The association between depression, perceived stress, and sexual function among adults attending primary health care services.” BMC Public Health. 2025.
11. Althof S, Rosen RC, et al. “Psychological perspectives on male erectile dysfunction: a reappraisal.” Sex Med Rev. 2025.
12. Lakhsassi L, Borg C, Freytag PL, de Jong PJ. “The impact of instruction-induced pain and disgust expectancies on sexual arousal in heterosexual women.” J Sex Res. 2025.
13. Roytman M, Barnett R, Rubin RS. “Female sexual function and dysfunction.” Obstet Gynecol. 2025.
14. Lakhsassi L, Borg C, Briken P, de Jong PJ. “Does heightened subjective sexual arousal lower pain in women if disgust is minimized?” PLoS One. 2025.
15. Chang H, Colonnello E, Ma D, […], Jannini EA. “The past, present, and future of Fangzhongshu (ancient Chinese sexual techniques).” Andrology. 2025.
16. Rowland DL. “Comment on: Men with delayed ejaculation report lower sexual satisfaction and more depressive symptoms.” Int J Impot Res. 2025.
17. de Mello Ferreira dos Reis M, Barros EAC, Monteiro L, […], Glina S. “Ideal time and self-reported time to ejaculate, frequent use of virtual pornography, and disordered sexual behaviour.” Einstein (Sao Paulo). 2025.
18. Rowland DL, McNabney S, Kövi Z, Hevesi K. “Are some forms of delayed/inhibited ejaculation more intractable than others? Establishing delayed ejaculation subtypes.” J Sex Med. 2025.
19. Zhu D, Pham Q, Wang C, […], Sansone A. “Erectile dysfunction and oxidative stress: a narrative review.” Int J Mol Sci. 2025.
2024
20. Rabiepoor S, Alizadeh S. “Comparison of psychobiosocial and biomedical approaches in sexual disorders.” Nurs Midwifery J. 2024.
21. Sucrese AM, Neff LA, Gleason MEJ. “‘Not now, I am too stressed’: stress and physical intimacy in early marriage.” Pers Soc Psychol Bull. 2024.
22. Briken P, Bőthe B, Carvalho J, […], Pfaus JG. “Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective.” Sex Med Rev. 2024.
23. Fous G, Bazzaroni C, Needle R, Favasuli S. “Sexual Integration Therapy: a sex-positive sexual health model supporting authentic sexual expression.” Sex Relatsh Ther. 2024.
24. Guimpel B. “TCCE des troubles sexuels.” Book chapter; 2024.
2023
25. Komisaruk BR, Del Cerro MCR, Goldstein I. “A neurologic excitation/inhibition ‘faucet model’ for orgasm and pain.” Sex Med Rev. 2023.
26. Rowland DL, McNabney S, Hevesi K. “Response to commentary on Rowland et al, ‘Similarities and differences between men with self-reported lifelong and acquired difficulty reaching orgasm.’” Int J Impot Res. 2023.
27. Can U, Kafkaslı A, Coşkun A, Karatas B. “Traumatic masturbation and erectile dysfunction: a matched case–control study.” Int J Urol. 2023.
2022
28. Sartin-Tarm A, Lorenz TK. “Sexual trauma moderates hormonal mediators of women’s sexual function.” Curr Sex Health Rep. 2022.
29. Komisaruk BR, Del Cerro MCR. “Orgasm and related disorders depend on neural inhibition combined with neural excitation.” Sex Med Rev. 2022.
30. Borg C, Lakhsassi L, de Jong PJ. “Sexual arousal and sexual pain disorders in women.” Book chapter; 2022.
31. Altıntaş E, Gül M. “Ejaculation and orgasmic disorders.” Book chapter; 2022.
32. Colonnello E, Fu W, Juo G, […], Jannini EA. “Effects and prospects of the integration of traditional Chinese medicine with Western biomedical approaches.” Integr Med Nephrol Androl. 2022.
33. Lê ĐH, Nguyễn TQ, Trần NT. “Hiếm muộn nam do chậm xuất tinh [Male infertility due to delayed ejaculation].” Pham Ngoc Thach J Med Pharm. 2022.
34. Rowland DL, Castleman JM, Bacys KR, Hevesi K. “Do pornography use and masturbation play a role in erectile dysfunction and relationship satisfaction in men?” Int J Impot Res. 2022.
35. Demir M, Işık M, Araz Ş, Ertas K. “An innovative approach to lifelong delayed ejaculation: does attachment style play a role?” Int Urol Nephrol. 2022.
36. Fiala L, Lenz J, Havelka P, Vetvicka V. “Delayed ejaculation in men with depressive disorders.” Andrologia.
2022.
37. Rowland DL, Morrow AL, Hamilton BD, Hevesi K. “Do pornography use and masturbation frequency play a role in delayed/inhibited ejaculation during partnered sex? A comprehensive and detailed analysis.” Sexes. 2022;3(1):115–133. doi:10.3390/sexes3010010
2021
38. Parish SJ, Cottler-Casanova S, Clayton AH, […], Reed GM. “The evolution of the female sexual disorder/dysfunction definitions, nomenclature, and classifications.” Sex Med Rev. 2021.
39. Hartmann U. “Gesprächsführung und Sexualanamnese.” Book chapter; 2021.
40. Sandström E, Fugl-Meyer K. “When ejaculation becomes the goal in itself: a psychodynamic approach to delayed ejaculation.” Am J Mens Health. 2021.
41. Yalçın H, Taşkıran M, Öztüren A. “Çocukluk yaşantılarının etkilediği cinsel işlev bozukluğu ve bir vakada bilişsel-davranışçı danışmanlık.” Istanbul Aydin Univ J Soc Sci. 2021.
.
42. Siegal A, Chubak B. “Pharmaceutical and energy-based management of sexual problems in women.” Urol Clin North Am. 2021;48(4):473–486.
2020
43. Beecken WD, Kersting M, Kunert W, […], Allen MS. “Thinking about pathomechanisms and current treatment of erectile dysfunction — ‘the Stanley Beamish problem.’ Review, recommendations, and proposals.” Sex Med Rev. 2020. doi:10.1016/j.sxmr.2020.11.004
44. Briken P. “An integrated model to assess and treat compulsive sexual behaviour disorder.” Nat Rev Urol. 2020;17:391–406. doi:10.1038/s41585-020-0343-7
45. Piche K, Mann U, Patel P. “Treatment of delayed ejaculation.” Curr Sex Health Rep. 2020.
2019
46. Parish SJ, Meston CM, Althof SE, […], Simon JA. “Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions — part III.” J Sex Med. 2019.
47. Lew-Starowicz Z, Czajkowska K. “Prevalence of sexual dysfunctions and associated risk factors in Poland.” Arch Med Sci. 2019.
48. Dwulit AD, Rzymski P. “The potential associations of pornography use with sexual dysfunctions: an integrative literature review.” J Clin Med. 2019.
49. Butcher MJ, Zubert T, Christiansen K, […], Seibel S. “Topical agents for premature ejaculation: a review.” Sex Med Rev. 2019.
50. Öztürk CŞ. “Psychological interventions in sexual dysfunctions.” Neuropsychiatr Investig. 2019.
51. Kunelaki R. “What is sober sex and how to achieve it?” Drugs Alcohol Today. 2019. doi:10.1108/DAT-11-2018-0064
2018
52. Colson MH, Cuzin B, Faix A, […], Huyghes E. “Erectile dysfunction, twenty years after.” Sexologies. 2018.
53. Abdel-Hamid IA, Ali OI. “Delayed ejaculation: pathophysiology, diagnosis, and treatment.” World J Mens Health. 2018;36(1):22–40.
2017
54. Levin RJ. “The human sexual response cycle.” In: Ishak WW, ed. Textbook of Clinical Sexual Medicine. Cham: Springer; 2017:39–51.
55. Langer R, Langer B, Mahajan R, Sharma E, Gupta RK, Kumari R. “Exploring psychosocial issues in patients of erectile dysfunction: a study in tertiary care setting.” Int J Med Sci Public Health. 2017;6(6):1050–1056.
2009
56. Wylie K, Mimoun S. “Sexual response models in women.” Maturitas. 2009;63(2):112–115.
2007
57. Traish AM, Guay AT, Spark RF; Testosterone Therapy in Women Study Group. “Commentary: are the Endocrine Society’s clinical practice guidelines on androgen therapy in women misguided?” J Sex Med. 2007;4(5):1223–1235.
2006
58. Diamond LE, Earle DC, Heiman JR, Rosen RC, Perelman MA, Harning R. “An effect on the subjective sexual response in premenopausal women with sexual arousal disorder by bremelanotide (PT-141), a melanocortin receptor agonist.” J Sex Med. 2006;3(4):628–638. doi:10.1111/j.1743-6109.2006.00268.x
