In National Legal Services Authority v. Union of India (‘NALSA’) and Navtej Johar v. Union of India (‘Navtej’), the Supreme Court made grand declarations for equal rights for transgender and intersex persons and broadened sex discrimination to prohibit discrimination on the basis of gender identity and sexual orientation.  The Supreme Court, most importantly, recognised that gender identity forms the core of one’s personal self and is based on self-determination, not on surgical or medical procedure. Despite this, transgender persons face discrimination on a regular basis on the basis of their gender identity. They are deprived of their basic rights and legal recognition unless they can produce proof of sex reassignment surgery through medical certificates.  The common argument by the State is that welfare measures and reservations for transgender persons will be misused and the only way in which such fraud can be tackled is by the beneficiary medically proving that they are indeed transgender. This paper discusses the evolution of the constitutional right to self-determination of gender identity in India under Article 21. It examines how the right to life also includes the right to bodily integrity which precludes the reliance of a medical model to decide gender identity and examines Indian and comparative jurisprudence on this issue. It argues for the need to abolish a medical model of gender identity recognition and a re-affirmation of the right to self-determination of gender identity and a rejection of the claim of misuse and fraud which has been used frequently in India without any empirical data. I argue that we need to move towards a transformative equality model which embraces gender variance, based on the affirmation of the right to self-determination of gender identity that is premised on the right to live one’s life with dignity, privacy and the recognition of one’s right to bodily integrity.