INTRODUCTION: The purported predominance of the biopsychosocial model is reviewed, including its underlying factors that determine the etiology and treatment of sexual disorders. We recommend that sexual health professionals embrace a broader recognition of all facets of the model. Periodic re-examination is necessary to optimize its strengths and minimize misapplication. OBJECTIVES: Improving the application of the full scope of the biopsychosocial model will help ensure that it remains robust and inclusive. Awareness of its limitations should prompt clinicians to expand their knowledge through continuing education. METHODS: Co-authors reviewed database searches, including PubMed, Google Scholar, and ClinicalTrials.gov. Publications, sexual society presentations, and guidelines were also considered, along with expert opinions. Authored by an intentionally recruited, diverse group of experts representing different disciplines, geographic regions, genders, and perspectives, our manuscript deserves substantial consideration. However, this work does not employ the rigorous methodology used by professional societies in producing guidelines. RESULTS: The biopsychosocial model is widely used; however, too many sex therapists and sexual medicine experts claim to adopt the model while merely paying it lip service. Clinicians support multidisciplinary approaches, yet siloed thinking persists. Collegial respect is increasing, but perspectives remain divided. While sex therapists recognize psychosocial nuances, many are unaware of biomedical advances in diagnosis and treatment that impact sexuality. Conversely, many physicians lack sufficient awareness of the cognitive, emotional, behavioral, and cultural factors contributing to sexual disorders. Physicians who prefer broader assessments often find that time constraints in clinical practice hinder multilayered engagement. CONCLUSION: 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."

Charles University Department of Psychology and Life Sciences Faculty of Humanities Prague 18200 Czech Republic

Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark

Harvard Medical School and Dana Farber Cancer Institute Dept of Supportive Oncology Cambridge Massachusetts 02215 United States

Michigan Medicine Department of Urology Ann Arbor Michigan 48109 United States

Sexologisk Klinik Sexological Clinic and Psykiatrisk Center København Psychiatric Centre Copenhagen 2200 Denmark

University of Utah School of Medicine Division of Urology Department of Surgery Salt Lake City Utah 84113 United States

Weill Cornell Medical College Department of Psychiatry New York NY 10021 United States; MAP Education and Research Foundation New York NY 1075 United States

Western University Department of Psychology and Obstetrics and Gynecology London ON N5X3R9 Canada

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