In the Netherlands, the prescribed mental healthcare is captured in quality standards. These standards include recommendations or prescriptions regarding proper treatment. There are several aspects of care:

1. Prevention
2. Screening
3. Diagnosis
4. Treatment
5. Recovery and reintegration

Each step requires different decisions regarding care. The quality standards can help with the decisions in the treatment and recovery phase. A quality standard outlines what quality care looks like for clinicians and patients for particular conditions. A quality standard is developed independently in a workgroup (e.g. patients, relatives, health professionals). This workgroup collects all information about the subject and based on this, they attempt to reach consensus.

There are three types of information that is used in the workgroup:

1. Evidence-based knowledge (i.e. scientific research)
2. Experience-based knowledge (i.e. experiences, wants and needs of patients)
3. Eminence-based knowledge (i.e. experience and opinions of

In the earliest diagnostic manuals, only inhibited sexual excitement was used to denote psychosexual disorders. However, this was indicated by a lack of a physiological response. In later diagnostic manuals, the FSAD diagnosis was added. However, the subjective arousal subtype was removed from this diagnosis in the DSM-4. This was done to make sure that the male-female similarity in sexual dysfunctions diagnoses could be maintained. The FSAD diagnosis only represents genital arousal and sees subjective arousal and sexual desire as the same thing while it is not.

Desire refers to the motivation to engage in and/or be receptive to a sexual event for sexual or non-sexual gratification. Genital arousal refers to genital changes in response to sexual stimuli. These changes may be associated with other bodily reactions (e.g. increased heart rate). Subjective arousal refers to positive mental engagement and focus in respone to a sexual stimulus. This

Sex-role identification refers to the degree to which we develop stereotypical gender traits (1), interests (2) and beliefs (3). Androgyny refers to a healthy integration of both masculine and feminine traits. This affords a greater cognitive and behavioural flexibility and is linked to better psychological health.

There are four reasons why gender should be viewed as a continuous variable:

1. There is considerable variability in the acquisition of masculine and feminine traits in the population.
2. This allows for less stereotyping in research.
3. There are different degrees in a person’s adherence to gender roles and stereotypes.
4. Nobody has only masculine or only feminine traits.

It appears as if femininity and masculinity are unrelated to sexual orientation. There is scientific evidence that gender identity and biological sex do not always align. This is not a pathology. The Hawthorne effect refers to people

The gender binary assumes that one’s category membership is biologically determined (1), apparent at birth (2), stable over time (3), a powerful predictor of psychological variables (4) and salient and meaningful to the self (5). There is an idea that brains are gendered (i.e. male and female brains). In neuroscience requires two assumptions:

1. Sex is a dimorphic system (i.e. system that can only take two forms).
2. Effect of sex on other systems (e.g. brain) is characterized by dimorphic outcome (e.g. male vs. female brain).

For a system to show dimorphism, each of its elements should be dimorphic. Furthermore, all the elements within an individual should be internally consistent (i.e. either all in the form typical of males or typical of females). The brain sex differences are context-dependent. However, it is unlikely that brains are internally consistent and dimorphic. Mosaicism (i.e. one typical