Advocating For a Transdisciplinary Perspective in Sexual Medicine

Abstract

Editor-in-Chief commentary on the 2014 re-launch of Current Sexual Health Reports. CommentaryThe first year of the re-launched Current Sexual Health Reports was successfully completed with 30 articles being carefully reviewed and shepherded to publication by our editorial board and section editors. They are deserving of our thanks and appreciation for their hard work, and we offer special thanks to our authors for their fine contributions. As we enter 2015, I also want to share a bit of personal history, and more importantly, a vision for this journal and the field of sexual medicine.In 1974, I returned to Columbia University from a year as Chief Intern in Medical Psychology specializing "psychophysiological disorders" at Duke. Back in NYC, I simultaneously began working with Helen Kaplan at Cornell and Ray Rosen who both served as my independent sex therapy dissertation advisors. By the new millennium, I had progressed from an earnest young sex therapist to an experienced advocate for a "combination treatment," approach to sexual disorders and concerns [1][2][3][4][5]. That perspective was influenced by our multidisciplinary work at Cornell but more significantly by my experience serving on numerous pharmaceutical advisory boards with colleagues from other professions of origin. Industry development programs all followed similar processes, which always included an array of consultants who presented their own specialties to each other, including urology, endocrinology, cardiology, gynecology, psychology, sociology, geriatrics, genetics, philosophy, statistics, research methodology, cultural anthropology, law, etc. The benefit to industry was economic, yet the consequence to many of us was a greatly enhanced multidisciplinary perspective.My multidisciplinary viewpoint has gradually morphed into a transdisciplinary one, and I now advocate for greater integration of knowledge and practice, not merely combining the efforts of different practitioners [6,7]. For sexual medicine to truly advance as a discipline (art and science), its specialized practitioners must not only draw from their own discipline's knowledge base but must also transcend the biases of their profession of origin in order to best address a common problem. Some have already made such a transition. These are the individuals who have integrated knowledge of other academic and clinical traditions while cultivating an ever-refined perspective on sexuality's mind/body conundrum.While the majority of health-care professionals pay lip service to a biopsychosocial-cultural model, many still maintain a view that is too narrowly shaped by their own professional training. Yet, evidence from laboratories (including fMRI studies) around the world supporting a mind/body integration becomes more abundant with each year that passes [8-10]. For example, a very recent fMRI study demonstrated how neurons in the prefrontal cortex contribute to cognitive and emotional processes and in doing so may both enhance and disrupt sexual desire and function [7]. Such processes ar...

Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

“…A safe effective medication for DE does not yet exist. When and if such a drug becomes available, this author’s transdisciplinary perspective supports the appropriate use of that medication when combined with counseling ( 6 ). However, there are still numerous techniques, which can be combined to treat DE including and not limited to sex education, cognitive-behavioral therapy, mindfulness, psychodynamic exploration of underlying conflicts, and/or couples therapy ( 56 , 57 ).…”

Biopsychosocial Management of Female Sexual Dysfunction: A Pilot Study of Patient Perceptions From 2 Multi-Disciplinary Clinics

“…The biopsychosocial model of sexual health management is often considered the gold standard because it emphasizes that sexual dysfunctions involve a complex interplay of biological, psychological, interpersonal, and sociocultural factors. 1 , 2 , 3 This model is the foundation for clinical theories and paradigms including the sexual tipping point, 4 the dual-control model, 5 and systemic sex therapy. 6 …”

“…This multi-disciplinary model is not unique to sexual health care delivery, as it has been shown to be effective in other health care settings, including primary care, obesity management, and cancer survivorship. 3 , 7 Specifically within the field of sexual health, a number of studies have shown promising results using this multi-disciplinary framework to successfully treat various sexual health concerns, particularly female sexual dysfunction. 8 , 9 , 10 , 11 , 12 , 13 Despite promising clinical outcomes of multi-disciplinary treatment for sexual health, much is unknown about this model.…”

The Biopsychosocial Model and the Sex-Positive Approach: an Integrative Perspective for Sexology and General Health Care

“…The BPS requires multidisciplinary cooperation, eclecticism and flexibility, elements that still cannot be taken for granted in any social or health care context. Most of the time, medical and non-medical health care providers work separately, making it difficult to establish cross-collaboration for both clinical and research purposes (Perelman, 2015). It is essential for different specialists to work together to share aims and treatment algorithms and recognize the specificity of each professional figure (Kirana et al, 2013;Reisman et al, 2015).…”