In Sri Lanka, ideas about the way men and women should look and act are deeply entrenched. Transgender people and others who challenge gender norms—including many lesbian, gay, bisexual, and intersex people—face a range of abuses from state officials and private individuals that compromise the quality and safety of their daily lives, and their ability to access services that are central to realizing basic human rights. Based on interviews with 61 lesbian, gay, bisexual, transgender, and intersex (LGBTI) people in four Sri Lankan cities, “All Five Fingers Are Not the Same” examines abuses against transgender people and others who do not conform to social expectations of gender and sexuality. Transgender people experience arbitrary detention, police mistreatment, and discrimination accessing health care, employment, and housing. These violations take place in a legal landscape that fails to recognize the gender identity of transgender people without abusive requirements and makes same-sex relations between consenting adults a criminal offense.