Institutional Coherence as a Condition for Policy Sustainability: Extending the OECD Input–Process–Output Model in the Context of Pakistan’s Transgender Policy

Institutional Coherence as a Condition for Policy Sustainability: Extending the OECD Input–Process–Output Model in the Context of Pakistan’s Transgender Policy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Institutional Coherence as a Condition for Policy Sustainability: Extending the OECD Input–Process–Output Model in the Context of Pakistan’s Transgender Policy Siti Hasliah Salleh, Hamza Iftikhar, Nor Ashikin Mohamed Yusof This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9216548/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Driven by global human rights movements, states increasingly adopt reforms centered on rights to address the marginalization of vulnerable groups. However, transplanting international normative frameworks into deeply embedded social and legal systems without rigorous contextualization can generate significant policy friction. This article addresses this theoretical gap by extending the Organisation for Economic Cooperation and Development (OECD) Input-Process-Output (IPO) evaluation logic, introducing institutional coherence as a critical precondition for long term policy sustainability. Using the Transgender Persons Protection of Rights Act 2018 in Pakistan as a Global South test case, this qualitative study evaluates the viability of unverified selfperceived gender identity as a policy instrument. Data were collected through systematic document analysis including the 2023 Federal Shariat Court judgment and Council of Islamic Ideology recommendations and guided elite interviews (n = 14) mapped across a Quadruple Helix stakeholder model. Thematic analysis was conducted using NVivo 12. Findings indicate that while the Act maximized administrative efficiency and immediate outputs, as reflected in a rapid increase in legal gender registrations, it generated substantial institutional tensions. Uncontextualized policy inputs intersected with constitutional and religious frameworks, producing normative incoherence. This misalignment contributed to systemic consequences, including inheritance disputes, the marginalization of biological intersex individuals, and institutional contestation. This article extends the OECD IPO evaluation framework by reconceptualizing institutional coherence as a structural precondition for policy sustainability. It introduces the Institutional Sustainability Threshold to explain how institutional alignment determines whether policy outputs can transition into durable outcomes in constitutionally layered governance systems. Other Public Policy Policy evaluation contextualization OECD Input-Process-Output Institutional Sustainability Threshold policy coherence Figures Figure 1 Figure 2 1 Introduction Sustainable public policy requires more than the attainment of short-term administrative outputs; it depends on maintaining long-term institutional coherence within complex and layered governance systems (Jenkins & Patashnik, 2012 ; Nilsson et al., 2012 ). In an era increasingly shaped by global human rights advocacy, international normative frameworks; most prominently the Yogyakarta Principles, have significantly influenced domestic legal reform. These frameworks promote legal recognition of gender based on self-perceived identity, conceptually decoupled from biological sex assigned at birth (O’Flaherty & Fisher, 2008 ). As a result, many states have adopted progressive legal transplants aimed at addressing the historical marginalization and violence experienced by transgender and gender-diverse populations. Pakistan represents a critical Global South test case of this dynamic. In May 2018, the Government of Pakistan enacted the Transgender Persons (Protection of Rights) Act (TA), followed by implementing Rules in 2020. The legislation granted legal recognition and broad socio-economic protections to transgender persons, locally known as Khawaja Sira or Hijra , based entirely on self-perceived gender identity (Khan & Alam, 2021 ). Historically, transgender individuals in Pakistan have faced systemic exclusion from education, healthcare, and formal employment, often relying on informal economies for survival (Farhat, 2020; Fatima et al., 2022 ). Internationally, the TA was widely regarded as a progressive milestone, particularly because it removed medical gatekeeping and enabled individuals to change their gender on official documents, including the Computerized National Identity Card (CNIC) issued by the National Database and Registration Authority (NADRA), through self-declaration alone. Yet policy transfer without contextual adaptation can generate institutional friction. Within Islamic jurisprudence, gender is understood as a binary construct linked to biological sex, particularly in matters of family law and inheritance ( nasab ), where wealth distribution ratios are sex-specific (Rana & Siddique, 2022 ). Article 227 of Pakistan’s Constitution requires that all legislation conform to Islamic injunctions (Alam, 2021 ). Critics, including the Independent Permanent Human Rights Commission of the Organisation of Islamic Cooperation, have argued that Sexual Orientation and Gender Identity (SOGI) frameworks conflict with foundational Islamic legal principles (Blitt, 2018 ). The TA’s reliance on self-perceived identity therefore intersected directly with deeply embedded constitutional and religious-legal structures. In the short term, the policy generated significant administrative outputs. Following implementation of the Rules, tens of thousands of individuals applied for gender modification through NADRA. Between 2021 and 2023, official records indicate over 28,000 applications shifting between male and female categories and more than 82,000 individuals selecting the “X” category. While such figures suggest enhanced administrative accessibility, they also triggered institutional contestation. In May 2023, the Federal Shariat Court invalidated key provisions of the TA, ruling that self-identification without biological basis contravened Islamic injunctions (JURIST, 2023). This episode raises a broader theoretical question: can rights-based policy reforms remain sustainable when internationally derived policy instruments interact with deeply embedded constitutional and normative orders? The Organisation for Economic Co-operation and Development (OECD) Input–Process–Output (IPO) framework remains one of the most widely applied approaches to policy evaluation, structured around relevance, coherence, efficiency, effectiveness, impact, and sustainability (OECD, 2021 ). However, despite its extensive application, limited scholarship interrogates how institutional coherence functions in constitutionally layered governance systems where religious and secular legal orders intersect. The framework typically treats coherence as one evaluative dimension among others, rather than as a structural precondition shaping whether policy outputs can transition into sustainable institutional outcomes. This article extends the OECD IPO evaluation framework by reconceptualizing institutional coherence as a structural precondition for policy sustainability rather than a subsidiary evaluative criterion. It introduces the concept of the Institutional Sustainability Threshold to explain how the degree of institutional alignment determines whether policy outputs can transition into durable institutional outcomes in constitutionally layered governance systems. 2 Conceptual Framework 2.1 The OECD Input–Process–Output Model: Analytical Architecture and Theoretical Limits The OECD has developed one of the most influential evaluation frameworks in contemporary public administration. Its IPO logic conceptualizes policy performance as the transformation of resources (inputs) through administrative mechanisms (processes) into outputs, long-term impacts, and sustainability outcomes (OECD, 2021 ). Embedded within this structure are six evaluative criteria: relevance, coherence, efficiency, effectiveness, impact, and sustainability. The strength of the OECD framework lies in its structured and comparative applicability. By linking programmatic performance to broader societal effects, it extends evaluation beyond narrow resource accounting to assess whether interventions generate durable public value. The inclusion of coherence and sustainability reflects recognition that policy success cannot be measured solely through immediate outputs, but must consider alignment and long-term viability. However, the framework implicitly assumes a relatively stable institutional environment. Coherence is typically treated as one evaluative dimension among others, which is assessing alignment with related policies rather than as a structural condition shaping the feasibility of the policy cycle itself. The IPO architecture presumes that once relevant inputs are efficiently processed, outputs can be translated into durable outcomes within an accommodating institutional context. In governance systems characterized by layered constitutional hierarchies and deeply embedded normative orders, this assumption may not hold. When policy inputs derive from external normative frameworks that diverge from foundational legal logics, institutional coherence may condition not merely implementation quality but the capacity of policy outputs to persist over time. This suggests the need to reconceptualize institutional coherence which is not as a subsidiary evaluation criterion, but as a constitutive precondition for policy sustainability. 2.2 Conceptualizing Policy Sustainability: Durability and Contextualization Policy sustainability extends beyond the survival of legislation. It refers to the long-term durability and adaptive resilience of a policy instrument within evolving political, socio-economic, and normative environments (Jenkins & Patashnik, 2012 ; Howlett et al., 2017 ; Jordan & Moore, 2023 ). Sustainability therefore reflects a policy’s capacity to maintain effectiveness while absorbing systemic shocks (Martikainen, 2025 ). Within evaluation theory, sustainability is sequentially dependent upon earlier stages of the policy chain: relevance, coherence, and effectiveness collectively shape whether long-term impact can be maintained. Sustainability is thus not an isolated endpoint but the cumulative outcome of institutional alignment. Empirical scholarship demonstrates that sustainable policy design requires balancing durability with contextual adaptation. Large-scale policy reforms frequently falter when imported models are insufficiently localized to prevailing institutional and cultural conditions. Without contextual calibration, policy instruments risk generating normative friction that undermines long-term resilience. This insight is particularly salient for outward-looking reforms grounded in international best practices or global normative standards. The long-term viability of such interventions depends on their ability to integrate with domestic constitutional structures and socio-legal traditions. 2.3 Institutional Coherence as a Structural Precondition Building upon this sustainability logic, institutional coherence emerges as a foundational structural condition. Institutional coherence refers to the degree of alignment and integration among governance institutions with respect to mandates, rules, and operational logics (Skovgaard, 2018 ). Coherent systems minimize fragmentation, reduce contradictory policy signals, and provide predictable governance environments that enable durable implementation. The relationship between sustainability and coherence is asymmetrical. While sustainable policies may reinforce institutional stability, coherence must exist at a minimum threshold for sustainability to become attainable. Incoherent institutional environments may generate short-term outputs but remain structurally vulnerable to contestation. Institutional coherence operates along two dimensions: Horizontal coherence concerns alignment across policy sectors to ensure that reforms in one domain do not undermine legal or administrative frameworks in another (Bolognesi & Pflieger, 2019 ). Vertical coherence refers to alignment across governance hierarchies from international norms to constitutional provisions and local implementation rules (Breuer et al., 2023 ). In layered constitutional systems particularly those grounded in religious jurisprudence, the challenge of maintaining vertical coherence becomes especially pronounced. Where imported normative frameworks embody ontological assumptions that diverge from constitutional foundations, institutional misalignment may become structurally embedded rather than administratively correctable. 2.4 Institutional Fit and Institutional Acceptance While coherence provides structural alignment, sustainability also depends on institutional fit and institutional acceptance. Institutional fit refers to the degree to which policy instruments correspond to the social, cultural, and legal systems they seek to regulate (Epstein et al., 2015 ). Even formally coherent policies may fail if they lack contextual compatibility with societal norms or implementation capacities. High institutional fit enhances administrative feasibility and reduces friction during execution. Institutional acceptance captures the process through which policy frameworks are socially legitimized and operationally integrated by implementing agencies and affected communities (Cohen et al., 2023 ). Acceptance is mediated by trust, perceived legitimacy, and cultural resonance. Policies that threaten deeply embedded values may face resistance, institutional inertia, or judicial contestation. Institutional fit often functions as a catalyst for acceptance. Conversely, weak fit can erode both horizontal and vertical coherence, producing systemic instability. 2.5 The Institutional Sustainability Threshold Taken together, institutional coherence, institutional fit, and institutional acceptance form a triadic architecture underpinning policy durability. Coherence provides structural alignment. Fit ensures contextual compatibility. Acceptance supplies legitimacy. A deficiency in any one dimension may prevent a policy from crossing what may be termed the Institutional Sustainability Threshold, which is the minimum level of structural and normative alignment required for policy outputs to evolve into durable institutional outcomes. This framework is particularly relevant for outward-looking, rights-based legal transplants introduced into governance systems characterized by layered constitutional hierarchies and strong normative foundations. 3 Methodology 3.1 Research Design This study adopts an interpretivist qualitative research design to examine how institutional coherence, institutional fit, and institutional acceptance shape policy sustainability within constitutionally layered governance systems. An interpretivist orientation is appropriate because the research seeks to understand how institutional actors interpret, negotiate, and contest policy instruments within normative and legal frameworks rather than to test causal relationships through statistical generalization. The study’s theoretical objective is to extend the OECD IPO evaluation framework by embedding institutional coherence as a structural precondition for policy sustainability. A qualitative design enables in-depth examination of the institutional tensions, stakeholder reasoning, and legal interpretations through which policy instruments interact with embedded constitutional and socio-legal structures. Such dynamics are difficult to capture through purely quantitative indicators. Analytically, the study operationalizes the OECD evaluation criteria (relevance, coherence, efficiency, effectiveness, impact, and sustainability) within an extended IPO matrix. Institutional coherence is examined through both vertical dimensions (alignment with constitutional and judicial authority) and horizontal dimensions (cross-sectoral integration across policy domains). Institutional fit is assessed in relation to socio-legal compatibility and administrative capacity, while institutional acceptance is examined through stakeholder perceptions, judicial responses, and institutional adjustments. This analytical structure enables systematic tracing of how policy inputs translate into procedural dynamics and downstream institutional outcomes. To clarify the analytical structure of the research, Fig. 1 illustrates how the extended IPO framework is operationalized in the empirical analysis. The framework links policy inputs specifically the relevance and institutional coherence of the self-perceived gender identity mechanism to procedural dynamics within the administrative registration process and to downstream outcomes related to effectiveness, impact, and long-term sustainability. This analytical framework guided the development of the interview protocol and structured the subsequent thematic analysis of institutional interactions across the policy cycle. 3.2 Case Selection Pakistan’s Transgender Persons (Protection of Rights) Act 2018 (TA) was selected as a critical case for examining institutional coherence in policy sustainability. The legislation represents an outward-looking rights-based legal reform influenced by international gender identity frameworks and implemented within a governance system characterized by strong constitutional and religious-legal structures. Pakistan provides significant analytical leverage for studying institutional alignment because its Constitution explicitly mandates conformity with Islamic jurisprudence under Article 227. This provision embeds religious jurisprudence within the constitutional hierarchy, creating a governance structure in which statutory reforms must operate simultaneously within secular administrative procedures and religious legal interpretation. Following case-study methodology (George & Bennett, 2005), Pakistan therefore constitutes a “most-likely” case in which tensions between internationally derived policy instruments and embedded constitutional norms are expected to become visible. Examining this case enables the study to explore how institutional coherence conditions policy sustainability in governance systems characterized by layered legal authority. 3.3 Sampling Strategy and Participants To capture the multi-actor nature of policy processes, the study employs purposive elite sampling structured through a Quadruple Helix framework, which conceptualizes policy ecosystems as interactions among government institutions, academic expertise, professional practice, and civil society (Sharif & Senin, 2020 ). This framework facilitates the inclusion of perspectives from actors directly involved in the formulation, implementation, interpretation, and societal reception of the TA. Participants were selected based on their institutional involvement in policy processes related to transgender legislation, including policy drafting, administrative implementation, professional engagement with gender-related healthcare, or community advocacy. Four participant categories were included: Government – policymakers and administrators involved in drafting the TA and implementing gender registration procedures within the NADRA; Academia – scholars specializing in public policy, gender studies, and Islamic jurisprudence; Professional Practice – clinical psychologists and medical practitioners working with gender dysphoria and intersex cases; Civil Society – transgender community representatives, activists, and social workers engaged in community advocacy. A total of 14 participants were interviewed, including four government officials, three academic experts, three clinical practitioners, and four civil society representatives. This sample size aligns with qualitative research standards indicating that thematic saturation in expert-based studies typically occurs within 11–13 interviews (Guest et al., 2006 ). Interviews continued until no substantively new analytical themes emerged. Elite interviewing is widely used in policy research to capture the perspectives of actors engaged in institutional decision-making processes and governance debates (Dexter, 2006), making it particularly suitable for examining contested policy environments involving multiple institutional stakeholders. 3.4 Data Collection Data collection followed a triangulated qualitative design combining documentary analysis and semi-structured elite interviews. 3.4.1 Documentary Analysis Primary legislative and judicial documents were systematically analyzed to capture institutional interpretations of the policy and its constitutional implications. Key documents included: the Transgender Persons (Protection of Rights) Act 2018; the Transgender Persons (Protection of Rights) Rules 2020; the 2022 recommendations of the Council of Islamic Ideology; the Federal Shariat Court judgment (19 May 2023, Shariat Petition No. 5/1 of 2020). These materials were treated as institutional texts reflecting competing normative logics and formal interpretations of constitutional coherence within Pakistan’s legal framework. 3.4.2 Semi-Structured Interviews Semi-structured interviews were conducted using an interview guide aligned with the extended OECD evaluation matrix. Questions explored participants’ perceptions of policy relevance, procedural integrity, institutional coherence, systemic impacts, and long-term sustainability. Interviews were conducted between February and May 2023 and lasted between 45 and 90 minutes. With participant consent, interviews were audio-recorded and transcribed verbatim. Interviews were conducted in English or Urdu depending on participant preference. Urdu transcripts were subsequently translated into English prior to coding to ensure analytical consistency while preserving contextual nuance. 3.5 Data Analysis The data were analyzed using reflexive thematic analysis (Braun & Clarke, 2022 ) supported by NVivo 12 software. The analytical strategy followed an abductive logic, iteratively moving between empirical observations and the conceptual framework to refine theoretical interpretations of institutional coherence and policy sustainability. The analysis proceeded through three stages. First, open coding was conducted to identify emergent themes across interview transcripts and documentary sources. Second, axial coding connected these themes to the extended IPO criteria and the analytical dimensions of institutional coherence, institutional fit, and institutional acceptance. Third, selective coding refined core explanatory mechanisms associated with the Institutional Sustainability Threshold, particularly those related to constitutional alignment, procedural safeguards, and stakeholder contestation. This layered coding process enabled systematic mapping of institutional tensions onto the extended sustainability framework while remaining open to new patterns emerging from the empirical data. 3.6 Validity, Reflexivity, and Ethical Considerations Several strategies were employed to enhance methodological rigor. First, data triangulation was conducted by comparing interview findings with legislative texts, judicial decisions, and institutional documents. This strengthened the credibility of the analysis by enabling the comparison of stakeholder perspectives with formal institutional interpretations. Second, peer debriefing and intercoder validation were undertaken by sharing coded transcripts and thematic matrices with two independent scholars specializing in public policy research. Differences in interpretation were resolved through analytical discussion. Third, reflexive memoing was maintained throughout the research process to document analytical decisions, trace interpretive development, and minimize potential researcher bias. These procedures enhanced the credibility, dependability, and confirmability of the findings. Ethical approval for the study was obtained prior to data collection. All participants provided informed consent, and anonymity was ensured through coded identifiers. Interview recordings and transcripts were securely stored and accessible only to the research team. 3.6.1 Researcher Positionality Given the interpretive nature of qualitative policy research, it is important to acknowledge the researcher’s positionality in relation to the study. The analysis is conducted from a public policy and governance perspective focusing on institutional evaluation rather than normative advocacy regarding gender identity debates. Reflexive memoing and peer debriefing were employed throughout the research process to ensure that interpretations remained grounded in empirical evidence while minimizing the influence of personal normative assumptions. 3.6.2 Data Transparency Statement In line with emerging standards for qualitative research transparency, the study documents its methodological procedures and analytical steps in detail. Due to the sensitive nature of elite interviews and the confidentiality agreements established with participants, interview transcripts cannot be publicly disclosed. However, anonymized coding structures, thematic matrices, and documentary sources used in the analysis are available from the author upon reasonable request. All legislative and judicial documents analyzed in the study are publicly accessible through official institutional records. 4 Research Findings The empirical findings are organized according to the extended IPO logic, integrating qualitative data from fourteen participants selected through a Quadruple Helix sampling model (government officials, academics, clinical psychologists, and transgender/intersex individuals) alongside documentary analysis. This structure enables a systematic examination of how stakeholders interpreted the relationship between policy design, institutional coherence, and long-term sustainability. 4.1 Policy Inputs: Institutional Coherence and Institutional Fit At the input stage, the evaluation criteria of relevance, vertical institutional coherence, and institutional fit capture whether the policy’s foundational assumptions align with the broader socio-legal environment. The data reveal divergent interpretations among stakeholder groups regarding the relevance and institutional compatibility of self-perceived gender identity as a policy instrument. From the perspective of transgender participants, recognition of self-perceived gender identity was widely described as empowering and socially relevant. Participant NT, a member of the transgender community, stated: Self-perceived identity holds significance in gender change applications, and it should be considered a fundamental right for everyone. People should have the autonomy to self-perceive their gender. Similarly, participant ZN emphasized the psychological significance of legal recognition: Due to my mental health and the challenges I faced with gender identity, self-perceived identity offered me the chance to undergo a gender change. For these stakeholders, the removal of medical prerequisites was interpreted as enhancing personal autonomy and aligning legal recognition with lived experience. In this sense, several participants suggested that the policy demonstrated strong social relevance for segments of the transgender community. In contrast, government officials and academic participants particularly those specializing in Islamic jurisprudence and constitutional law expressed concerns regarding vertical institutional coherence. Participant US observed: Identifying or changing one's gender based on self-perceived identity is not allowed as it contradicts Pakistan's Islamic principles, as stated in Article 227. Participant TB similarly noted: In Pakistan Islamic law is dominating, so self-perceived identity is not relevant to this legal framework and serious reservations have been shown by stakeholders of society. Document analysis of the 2023 Federal Shariat Court (FSC) judgment reflected comparable reasoning. The Court distinguished between intersex individuals recognized within Islamic jurisprudence on the basis of biological attributes and transgender individuals defined through self-perception. The judgment indicated that Islamic law recognizes gender identity grounded in physical characteristics but does not recognize identity based solely on subjective perception. These findings suggest that while the policy input was perceived by some beneficiaries as socially relevant, several institutional actors interpreted the self-perception mechanism as misaligned with the constitutional framework grounded in Islamic jurisprudence. Such perceptions shaped broader debates regarding institutional fit at the foundational stage of the policy cycle. 4.2 Procedural Dynamics: Administrative Efficiency and Debates over Procedural Safeguards The process stage of the extended IPO framework evaluates administrative efficiency and procedural integrity. Participants widely acknowledged that the removal of medical gatekeeping improved the accessibility of gender recognition procedures. Participant RSK commented: It values individuals' free will… It does not mandate strict requirements like surgery or medical documentation, showing a progressive approach. Clinical psychologist CP2 similarly observed: This methodology prioritizes individuals' autonomy in identifying and validating their gender identity without external medical constraints or mandates. From this perspective, the revised procedures were widely interpreted as administratively efficient and supportive of individual autonomy. At the same time, several government officials and legal scholars raised concerns regarding the absence of procedural safeguards and the potential implications for horizontal institutional coherence. One recurring theme involved inheritance law, which distributes shares according to biological sex within Islamic jurisprudence. Participant TB noted: The major subject to abuse or fraud is the law of inheritance where people can claim more share in wealth after changing their genders. Participant AI further elaborated: The absence of self-perceived identity regulation can result in fraudulent claims or misrepresentations, disrupting the intended distribution and undermining principles of justice within Islamic inheritance laws. While participants did not present systematic evidence of widespread abuse, these statements reflect perceived governance risks associated with the absence of verification mechanisms. Participants also highlighted cross-sectoral institutional intersections, particularly between civil registration systems and other legal domains. Participant SMH noted: The current NADRA registration process differs from the previous one, causing inconsistent practices. The new approach doesn't follow standard protocols like using birth certificates, which may lead to a breakdown in the connection with reliable systems. These observations suggest that although the policy was widely perceived as procedurally efficient, some institutional actors interpreted the removal of safeguards as introducing administrative ambiguity and potential tensions across interconnected policy domains. 4.3 Outputs, Outcomes, and Institutional Implications At the output stage, participants acknowledged that the policy generated measurable administrative results and expanded access to formal documentation. Participant ZN stated: On the basis of their gender recognition, they are mainstreamed and socially included in society. Government is working on social and economic assistance such as many transgenders are employed in different government institutions. For some community members, legal recognition facilitated access to banking services, voting rights, and employment quotas. In terms of immediate outputs, the policy was widely perceived as achieving its stated objective of simplifying gender registration procedures. However, participants across institutional domains also described a range of downstream implications that they associated with broader institutional tensions. One recurring concern involved the legal categorization of intersex (Khunsa) individuals. Several medical and legal participants suggested that the statutory definition of “transgender” could encompass both biological intersex conditions and self-perceived gender identity. Participant NK, identifying as intersex, explained: Gender change without birth proof can deny the legal rights of intersex people. Those who are not intersex by birth can change their genders and become intersex person according to the definition of the Act. Participant AI similarly stated: Integrating self-perceived identity adds vulnerability to the situation, hindering the achievement of policy goals. Employment benefits may favor binary genders over genuine intersex individuals. These observations indicate that some stakeholders perceived the definitional scope of the Act as creating competition over access to benefits or quotas originally intended for biologically intersex persons. Participants also referenced broader patterns of societal reception. Participant TB noted that the policy had: … the potential to pose challenges to societal and familial structures, as traditional understandings of gender roles and relationships may be impacted. Several respondents described instances of family or community resistance experienced by individuals who altered their legal gender identity. These narratives suggest that while the policy expanded formal recognition, its social reception varied across communities and institutional settings. Taken together, these findings illustrate how strong administrative outputs coexisted with perceived cross-sectoral and socio-cultural tensions. 4.4 Stakeholder Perspectives on Policy Recalibration The findings also reveal differing perspectives regarding possible policy recalibration. Several academic and governmental participants suggested that self-perceived gender identity should not function as the sole legal basis for gender modification. Participant CP2 proposed: Specific diagnostic criteria and treatment plans tailored to intersex versus transgender people may be necessary to provide comprehensive, ethical, and effective healthcare to both communities. Participant TB suggested reinstating certain institutional safeguards: Intersex persons must be diagnosed through a medical board, but at the same time psychiatric evaluation of transgender must be adopted. These views align with recommendations issued by the Council of Islamic Ideology (CII), which emphasize medical verification in cases involving biological ambiguity. At the same time, transgender community participants did not uniformly support such recalibration and continued to emphasize autonomy and self-identification as central principles of gender recognition. Taken together, these perspectives suggest that stakeholders across institutional domains interpreted long-term sustainability as contingent upon recalibrating the balance between individual autonomy, administrative efficiency, and constitutional alignment. Rather than indicating immediate policy failure, these debates highlight how differing interpretations of institutional coherence, institutional fit, and societal acceptance shape assessments of policy viability within a constitutionally layered governance system. 4.5 Synthesis of the IPO Result Chain: Cognitive Mapping To synthesize the qualitative findings and illustrate the interconnections among emergent themes, a cognitive map was generated using NVivo 12 based on the coded dataset. The figure visually represents the thematic relationships identified across the IPO chain and provides an integrated depiction of how stakeholders interpreted institutional coherence, procedural dynamics, and longer-term policy implications. As illustrated in Fig. 2 , the cognitive map organizes the findings across three primary domains: Input-level factors , including stakeholder interpretations of relevance, vertical institutional coherence, and institutional fit; Process-level dynamics , particularly administrative efficiency, debates surrounding procedural safeguards, and cross-sectoral institutional intersections; Output-level implications , including immediate administrative outputs, institutional contestation, and patterns of societal reception. The visual synthesis highlights how stakeholder interpretations at the input stage were linked to downstream evaluations of administrative integrity and long-term sustainability. Concerns regarding constitutional alignment and definitional scope were thematically connected to cross-sectoral institutional intersections, particularly inheritance law, quota allocation systems, and judicial review processes. Conversely, themes related to autonomy and psychological well-being were linked to positive assessments of procedural accessibility and short-term administrative effectiveness. Importantly, the cognitive map does not establish linear causality but illustrates patterned associations within the qualitative data. The synthesis suggests that perceptions of institutional coherence and institutional fit at the input stage influenced how stakeholders interpreted subsequent procedural and outcome dimensions. The figure therefore complements the analytical narrative by demonstrating how relevance, coherence, efficiency, and societal reception were thematically interconnected within the extended IPO evaluation framework. Taken together, the findings illustrate how stakeholder interpretations of relevance, institutional coherence, and procedural safeguards interact across the Input–Process–Output chain. While the policy generated notable administrative outputs and expanded formal recognition for some beneficiaries, the data also reveal persistent tensions regarding constitutional alignment, cross-sectoral legal interactions, and societal reception. These dynamics suggest that policy performance cannot be evaluated solely through immediate outputs or administrative efficiency. Instead, the sustainability of the intervention appears contingent upon whether the policy’s foundational assumptions remain compatible with the broader institutional architecture in which it operates. This observation provides the empirical basis for the concept of the Institutional Sustainability Threshold, which is further elaborated in the following discussion. 5 Discussion: Institutional Coherence and the Sustainability of Legal Transplants The empirical findings challenge the assumption that the successful adoption of internationally benchmarked rights frameworks necessarily translates into sustainable domestic governance. Findings from the Pakistani case suggest that policy sustainability is not determined solely by administrative efficiency or output volume, but by the degree of institutional coherence embedded at the input stage of the policy cycle. By extending the OECD IPO evaluation framework, this study highlights how the long-term viability of policy reforms depends on the alignment between policy design and the institutional architecture within which implementation occurs. More broadly, the findings contribute to ongoing debates in policy studies concerning the contextualization of policy transfer and legal transplants. While internationally derived norms may offer progressive policy solutions, their sustainability often depends on how effectively they are integrated within existing constitutional, legal, and socio-cultural frameworks. The Pakistani case therefore illustrates how institutional alignment or the lack thereof can shape the trajectory of policy implementation beyond the immediate stage of administrative outputs. 5.1 Repositioning Coherence within the IPO Logic Within the conventional OECD evaluation framework, coherence is typically treated as one evaluative criterion among several others, assessed alongside relevance, efficiency, effectiveness, impact, and sustainability. The findings of this study suggest that in constitutionally layered governance systems, coherence may function not merely as an assessment category but as a structural precondition influencing whether policy interventions can generate durable outcomes. In the case examined, administrative procedures for gender recognition were widely perceived as efficient and accessible. The removal of medical gatekeeping simplified gender registration and produced measurable administrative outputs. However, the findings also indicate that tensions regarding constitutional alignment emerged early in the policy cycle, particularly among actors responsible for interpreting Islamic jurisprudence and constitutional law. From this perspective, judicial intervention did not appear as an isolated institutional reaction but rather as a manifestation of institutional tensions embedded at the policy’s design stage. This observation suggests a potential limitation in linear interpretations of the IPO logic, which often assume that effective inputs and efficient processes will naturally lead to sustainable outcomes. Instead, the findings indicate that policy outputs may appear operationally successful while simultaneously generating institutional contestation when foundational inputs remain misaligned with prevailing legal and normative frameworks. This interpretation resonates with institutionalist scholarship emphasizing that policy reforms introduced into dense governance environments are filtered through existing legal structures, organizational routines, and constitutional constraints. 5.2 Mechanism: From Normative Misalignment to Institutional Contestation The findings allow the identification of a sequential mechanism linking institutional misalignment to sustainability constraints. This mechanism can be summarized in five stages: Normative Input Divergence – Policy inputs derived from international normative frameworks diverge from entrenched constitutional or legal logics. Procedural Vulnerability – Administrative reforms designed to enhance efficiency reduce procedural safeguards, potentially weakening institutional buffering capacity. Cross-Sectoral Tension – Interactions between the new policy instrument and adjacent legal domains—such as inheritance law, civil registration systems, and welfare allocations—generate horizontal institutional strain. Institutional Contestation – Accumulated tensions trigger institutional responses within the governance system, including judicial review or political debate. Sustainability Constraint – The long-term viability of the policy becomes contingent upon institutional recalibration or structural realignment. Elements of this sequence were reflected in the empirical findings. Debates over inheritance law, definitional scope, and constitutional compatibility emerged alongside administrative implementation, eventually culminating in judicial scrutiny of the legislation. The mechanism therefore suggests that sustainability in layered governance systems may depend less on output success than on the extent to which policy inputs remain integrated with existing institutional logics. Importantly, this mechanism does not imply that administrative efficiency is inherently problematic. Rather, it indicates that efficiency gains may accelerate the diffusion of policy instruments whose institutional compatibility remains contested. In such contexts, procedural streamlining may unintentionally amplify institutional tensions by scaling reforms more rapidly than institutional structures can absorb. 5.3 The Institutional Sustainability Threshold To conceptualize the relationship between institutional coherence and policy durability, this study advances the concept of the Institutional Sustainability Threshold (IST). The threshold refers to the minimum level of structural and normative alignment required for policy outputs to transition into durable institutional outcomes. It serves as an analytical device for identifying the point at which institutional misalignment begins to generate sustained contestation within a governance system. Unlike conventional evaluation criteria, which typically assess outcomes after implementation, the Institutional Sustainability Threshold conceptualizes sustainability as conditional upon the compatibility of policy inputs with the broader institutional environment. Within the extended IPO framework, sustainability is therefore not only a downstream outcome but also a function of institutional alignment at earlier stages of the policy cycle. The threshold operates across three interrelated dimensions. First, vertical institutional coherence. Policies must align with the hierarchical structure of constitutional authority. In governance systems where constitutional provisions incorporate religious or normative legal frameworks, statutory reforms that diverge from foundational principles may encounter corrective mechanisms such as judicial review. When vertical misalignment exceeds institutional tolerance, sustainability becomes contingent upon constitutional reinterpretation or legislative recalibration. Second, horizontal institutional integration. Policies must maintain consistency across sectoral domains. Reforms in civil identification systems intersect with a range of legal and administrative domains, including family law, inheritance structures, welfare allocation, and regulatory regimes governing public spaces. Where cross-sectoral implications are insufficiently coordinated, institutional fragmentation may emerge. Horizontal incoherence may not immediately prevent implementation, but it increases the likelihood of downstream institutional friction. Third, institutional fit and societal acceptance. Beyond formal legal alignment, policy instruments must resonate with prevailing socio-cultural norms and administrative capacities. Institutional fit reduces interpretive ambiguity, while societal acceptance contributes to legitimacy that stabilizes policy implementation. Where such alignment is weak, institutional actors may reinterpret or selectively enforce policy provisions, potentially undermining long-term durability. The Institutional Sustainability Threshold is crossed when these dimensions collectively provide sufficient institutional absorptive capacity for the policy instrument. Below the threshold, misalignment accumulates across stages of the policy cycle, increasing the likelihood of institutional contestation. Above it, policy outputs are more likely to become routinized within institutional practice. Crucially, the threshold is dynamic rather than fixed. Its position varies depending on the rigidity of constitutional hierarchies, the authority of judicial institutions, and the density of socio-cultural embeddedness. In systems characterized by strong constitutional review and deeply entrenched normative orders, the threshold may be comparatively narrow. In more pluralistic institutional environments, governance systems may absorb greater degrees of normative innovation before contestation escalates. By conceptualizing sustainability as a function of institutional absorptive capacity, the Institutional Sustainability Threshold extends existing discussions of institutional fit in governance literature. While institutional fit typically focuses on the compatibility between governance arrangements and social contexts, the threshold framework emphasizes the minimum level of alignment required for policy outputs to stabilize within layered institutional systems. 5.4 Implications for Evaluation Theory and Policy Transfer The findings contribute to policy evaluation scholarship in three principal ways. First, they reposition institutional coherence from a supplementary evaluative indicator to a constitutive condition within the IPO framework. This reframing shifts attention from retrospective assessments of alignment to proactive examination of structural compatibility during policy design. Second, the analysis highlights the limitations of output-centric evaluation metrics. High administrative throughput may signal short-term effectiveness while masking underlying institutional tensions that undermine long-term sustainability. Third, the study contributes to scholarship on policy transfer and legal transplants, particularly in Global South contexts. Research on policy transfer has long emphasized that imported policy models must adapt to domestic institutional environments. The findings reinforce this insight by demonstrating how the sustainability of rights-based reforms may depend on their compatibility with constitutional structures, legal traditions, and socio-cultural norms. Although illustrated through the Pakistani case, the conceptual framework proposed here may also be relevant for other governance systems characterized by layered legal orders, strong constitutional review mechanisms, or intersections between secular and religious legal frameworks. In such contexts, institutional coherence may play a decisive role in determining whether externally derived policy models can be sustainably integrated into domestic governance structures. 5.5 From Efficiency to Durability The broader theoretical implication of this study is that sustainable governance requires balancing procedural efficiency with institutional compatibility. Administrative streamlining may expand access to recognition, rights, and public services; however, efficiency alone cannot guarantee policy durability if institutional alignment remains contested. The Pakistani case illustrates how policy instruments derived from international norms may achieve rapid administrative implementation while simultaneously generating debates regarding constitutional compatibility and institutional fit. These dynamics highlight the importance of embedding policy innovations within existing governance architectures through calibrated procedural safeguards, cross-sectoral coordination, and ongoing institutional dialogue. Viewed through the lens of the Institutional Sustainability Threshold, policy sustainability becomes less a retrospective judgment about outputs and more a question of institutional architecture. Durable governance emerges when policy inputs, procedural design, and societal reception remain sufficiently aligned with the institutional structures within which implementation occurs. 6 Conclusion This study evaluated Pakistan’s Transgender Persons (Protection of Rights) Act 2018 through an extended application of the OECD IPO framework. By embedding institutional coherence as a structural precondition within the evaluation logic, the research demonstrates that policy sustainability cannot be inferred from administrative efficiency or high output volume alone. The findings indicate that while the policy effectively expanded access to legal gender recognition and streamlined administrative procedures, tensions at the level of constitutional alignment and cross-sectoral integration constrained its long-term durability. The judicial invalidation of key provisions illustrates how misalignment at the input stage can reverberate across the policy cycle, affecting downstream institutional stability. The principal theoretical contribution of this study lies in repositioning institutional coherence from a subsidiary evaluative criterion to a constitutive condition of sustainability within the IPO architecture. In doing so, the article advances the concept of the Institutional Sustainability Threshold, defined as the minimum degree of structural and normative alignment required for policy outputs to evolve into durable institutional outcomes. This conceptual refinement contributes to evaluation theory by foregrounding institutional context as a determinant of long-term policy viability. The case further underscores the importance of contextualization in outward-looking legal reforms, particularly within Global South governance systems characterized by layered constitutional hierarchies and embedded normative orders. The findings do not suggest that international rights frameworks are inherently incompatible with such systems. Rather, they demonstrate that sustainable integration requires calibrated adaptation, cross-sectoral coordination, and careful alignment with foundational legal principles. More broadly, the study highlights a critical lesson for policy transfer scholarship: high performance in the process and output stages does not guarantee systemic sustainability. Durable governance emerges when normative ambition is matched by institutional coherence. Declarations The research leading to these results received funding from Universiti Teknologi Malaysia through the International Doctoral Fund awarded to support the doctoral research of Hamza Iftikhar. Acknowledgement This article builds upon the doctoral research of (name) conducted at (university name) . The research was financially supported by the (fund) . The authors gratefully acknowledge this support. References Alam I (2021) Identity crisis and rights in trouble: Transgenders in Islamic Republic of Pakistan. J Political Stud 28(1):55–72 Blitt RC (2018) The Organization of Islamic Cooperation’s response to sexual orientation and gender identity rights: A challenge to equality and nondiscrimination under international law. Transnatl Law Contemp Probl 28:89–144 Bolognesi T, Pflieger G (2019) The coherence(s) of institutional resource regimes: Typology and assessments from the case of water supply management. Environ Sci Policy 97:51–60. https://doi.org/10.1016/j.envsci.2019.04.004 Braun V, Clarke V (2022) Thematic analysis: A practical guide. Sage Breuer A, Janetschek H, Malerba D (2023) Translating sustainable development goals into domestic policies: Institutional coherence and policy integration. Sustainability 15(3):2101. https://doi.org/10.3390/su15032101 Cohen N, Jagers SC, Matti S (2023) Institutional acceptance and policy legitimacy: The role of trust and cultural alignment. Policy Stud J 51(2):455–473. https://doi.org/10.1111/psj.12489 Epstein G, Pittman J, Alexander SM, Berdej S, Dyck T, Kreitmair U, Rathwell KJ, Villamayor-Tomas S, Vogt J (2015) Institutional fit and the sustainability of social–ecological systems. Curr Opin Environ Sustain 14:34–40. https://doi.org/10.1016/j.cosust.2015.03.005 Farhat SN, Abdullah MD, Hali SM, Iftikhar H (2020) Transgender law in Pakistan: Some key issues. Policy Perspect 17(1):7–33 Fatima H, Anwar M, Iqbal S (2022) Socio-economic marginalization of transgender communities in Pakistan. J Gend Stud 31(5):612–627. https://doi.org/10.1080/09589236.2021.1967410 Gertler PJ, Martinez S, Premand P, Rawlings LB, Vermeersch CMJ (2016) Impact evaluation in practice, 2nd edn. World Bank Guest G, Bunce A, Johnson L (2006) How many interviews are enough? Field methods 18(1):59–82. https://doi.org/10.1177/1525822X05279903 Howlett M, Mukherjee I, Rayner J (2017) The elements of effective program design: A two-level analysis. In: Howlett M, Mukherjee I (eds) Handbook of policy formulation. Edward Elgar, pp 129–144 Jenkins A, Patashnik EM (2012) Living legislation: Durability, change, and the politics of American lawmaking. University of Chicago Press Jordan A, Moore B (2023) Policy durability and flexibility in European climate governance. J Eur Public Policy 30(6):987–1005. https://doi.org/10.1080/13501763.2022.2044678 Khan A, Alam M (2021) Legal recognition and transgender rights in Pakistan. Asian J Comp Law 16(2):243–266. https://doi.org/10.1017/asjcl.2021.15 Martikainen T (2025) Agricultural adaptation and policy sustainability under the Common Agricultural Policy. Food Policy 120:102504 Nilsson M, Zamparutti T, Petersen JE, Nykvist B, Rudberg P, McGuinn J (2012) Understanding policy coherence: Analytical framework and examples of sector–environment policy interactions in the EU. Environ Policy Gov 22(6):395–423. https://doi.org/10.1002/eet.1589 OECD (2021) Applying evaluation criteria thoughtfully. Organisation for Economic Co-operation and Development O’Flaherty M, Fisher J (2008) Sexual orientation, gender identity and international human rights law: Contextualising the Yogyakarta Principles. Hum Rights Law Rev 8(2):207–248. https://doi.org/10.1093/hrlr/ngn009 Rana MA, Siddique O (2022) Islamic inheritance law and contemporary legal reforms in Pakistan. Islamic Law Soc 29(3):365–389. https://doi.org/10.1163/15685195-20220004 Sharif N, Senin AA (2020) The quadruple helix model and innovation systems. J Innov Knowl 5(2):91–99. https://doi.org/10.1016/j.jik.2019.12.002 Skovgaard J (2018) Policy coherence and organizational cultures: Energy efficiency and greenhouse gas reduction targets. Environ Policy Gov 28(5):332–343. https://doi.org/10.1002/eet.1819 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9216548","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":611643781,"identity":"66debf79-9e73-4e8c-9917-282dc39f7b22","order_by":0,"name":"Siti Hasliah Salleh","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYDACZgaGw0BKho2Bh/EBkVqYwVp4gFqYDRgSiLSGGaQFpEuCKC3y7fwHDxfU1PHwsZ89Vs37YxuD7gwC+gwOAx0249hhHjaevLTbPAm3GcxuENIC8gsP2wGgX3LMiNMi3wzS8q+Oh43/jVkxUVoYQA7jbWMG+j3HjJk4hx1mNjjM2wd0m8QbY8k5QO+YnXlAwGH9Bx9/5vlWJyffn2P44Y3NbTmz44Qchg54GARI1cLAwH+AZC2jYBSMglEwvAEA2Z88Yt4TefoAAAAASUVORK5CYII=","orcid":"","institution":"Universiti Teknologi Malaysia, Malaysia","correspondingAuthor":true,"prefix":"","firstName":"Siti","middleName":"Hasliah","lastName":"Salleh","suffix":""},{"id":611643782,"identity":"052dead4-4043-4a64-ad86-9c7d6fba8934","order_by":1,"name":"Hamza Iftikhar","email":"","orcid":"","institution":"National University of Sciences and Technology","correspondingAuthor":false,"prefix":"","firstName":"Hamza","middleName":"","lastName":"Iftikhar","suffix":""},{"id":611643783,"identity":"5317f6cd-0d0f-476a-91dd-124a4fa92a43","order_by":2,"name":"Nor Ashikin Mohamed Yusof","email":"","orcid":"","institution":"Universiti Teknologi Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Nor","middleName":"Ashikin Mohamed","lastName":"Yusof","suffix":""}],"badges":[],"createdAt":"2026-03-24 23:54:36","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-9216548/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9216548/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105465833,"identity":"e4d2cb19-5b83-4678-bca4-70f41337c6d4","added_by":"auto","created_at":"2026-03-26 10:49:38","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":36491,"visible":true,"origin":"","legend":"\u003cp\u003eAnalytical operationalization of the extended OECD Input–Process–Output framework\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9216548/v1/6a881e4e280580aaffe3a23f.png"},{"id":105465834,"identity":"0db345a4-43a9-4f3c-a52c-89ffdde74bdc","added_by":"auto","created_at":"2026-03-26 10:49:38","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":58637,"visible":true,"origin":"","legend":"\u003cp\u003eCognitive mapping of institutional coherence within the extended IPO framework.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9216548/v1/79c38746415b8c20c7f820af.png"},{"id":105465836,"identity":"a589b6c0-9ec8-4900-8783-27d99a4ac61b","added_by":"auto","created_at":"2026-03-26 10:49:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1148296,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9216548/v1/0db01f73-4f85-43a6-b658-a8d4d6457cff.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eInstitutional Coherence as a Condition for Policy Sustainability: Extending the OECD Input–Process–Output Model in the Context of Pakistan’s Transgender Policy\u003c/p\u003e","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eSustainable public policy requires more than the attainment of short-term administrative outputs; it depends on maintaining long-term institutional coherence within complex and layered governance systems (Jenkins \u0026amp; Patashnik, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Nilsson et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). In an era increasingly shaped by global human rights advocacy, international normative frameworks; most prominently the Yogyakarta Principles, have significantly influenced domestic legal reform. These frameworks promote legal recognition of gender based on self-perceived identity, conceptually decoupled from biological sex assigned at birth (O\u0026rsquo;Flaherty \u0026amp; Fisher, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). As a result, many states have adopted progressive legal transplants aimed at addressing the historical marginalization and violence experienced by transgender and gender-diverse populations.\u003c/p\u003e \u003cp\u003ePakistan represents a critical Global South test case of this dynamic. In May 2018, the Government of Pakistan enacted the Transgender Persons (Protection of Rights) Act (TA), followed by implementing Rules in 2020. The legislation granted legal recognition and broad socio-economic protections to transgender persons, locally known as \u003cem\u003eKhawaja Sira\u003c/em\u003e or \u003cem\u003eHijra\u003c/em\u003e, based entirely on self-perceived gender identity (Khan \u0026amp; Alam, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Historically, transgender individuals in Pakistan have faced systemic exclusion from education, healthcare, and formal employment, often relying on informal economies for survival (Farhat, 2020; Fatima et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Internationally, the TA was widely regarded as a progressive milestone, particularly because it removed medical gatekeeping and enabled individuals to change their gender on official documents, including the Computerized National Identity Card (CNIC) issued by the National Database and Registration Authority (NADRA), through self-declaration alone.\u003c/p\u003e \u003cp\u003eYet policy transfer without contextual adaptation can generate institutional friction. Within Islamic jurisprudence, gender is understood as a binary construct linked to biological sex, particularly in matters of family law and inheritance (\u003cem\u003enasab\u003c/em\u003e), where wealth distribution ratios are sex-specific (Rana \u0026amp; Siddique, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Article 227 of Pakistan\u0026rsquo;s Constitution requires that all legislation conform to Islamic injunctions (Alam, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Critics, including the Independent Permanent Human Rights Commission of the Organisation of Islamic Cooperation, have argued that Sexual Orientation and Gender Identity (SOGI) frameworks conflict with foundational Islamic legal principles (Blitt, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). The TA\u0026rsquo;s reliance on self-perceived identity therefore intersected directly with deeply embedded constitutional and religious-legal structures.\u003c/p\u003e \u003cp\u003eIn the short term, the policy generated significant administrative outputs. Following implementation of the Rules, tens of thousands of individuals applied for gender modification through NADRA. Between 2021 and 2023, official records indicate over 28,000 applications shifting between male and female categories and more than 82,000 individuals selecting the \u0026ldquo;X\u0026rdquo; category. While such figures suggest enhanced administrative accessibility, they also triggered institutional contestation. In May 2023, the Federal Shariat Court invalidated key provisions of the TA, ruling that self-identification without biological basis contravened Islamic injunctions (JURIST, 2023).\u003c/p\u003e \u003cp\u003eThis episode raises a broader theoretical question: can rights-based policy reforms remain sustainable when internationally derived policy instruments interact with deeply embedded constitutional and normative orders?\u003c/p\u003e \u003cp\u003eThe Organisation for Economic Co-operation and Development (OECD) Input\u0026ndash;Process\u0026ndash;Output (IPO) framework remains one of the most widely applied approaches to policy evaluation, structured around relevance, coherence, efficiency, effectiveness, impact, and sustainability (OECD, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, despite its extensive application, limited scholarship interrogates how institutional coherence functions in constitutionally layered governance systems where religious and secular legal orders intersect. The framework typically treats coherence as one evaluative dimension among others, rather than as a structural precondition shaping whether policy outputs can transition into sustainable institutional outcomes.\u003c/p\u003e \u003cp\u003eThis article extends the OECD IPO evaluation framework by reconceptualizing institutional coherence as a structural precondition for policy sustainability rather than a subsidiary evaluative criterion. It introduces the concept of the Institutional Sustainability Threshold to explain how the degree of institutional alignment determines whether policy outputs can transition into durable institutional outcomes in constitutionally layered governance systems.\u003c/p\u003e"},{"header":"2 Conceptual Framework","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 The OECD Input\u0026ndash;Process\u0026ndash;Output Model: Analytical Architecture and Theoretical Limits\u003c/h2\u003e \u003cp\u003eThe OECD has developed one of the most influential evaluation frameworks in contemporary public administration. Its IPO logic conceptualizes policy performance as the transformation of resources (inputs) through administrative mechanisms (processes) into outputs, long-term impacts, and sustainability outcomes (OECD, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Embedded within this structure are six evaluative criteria: relevance, coherence, efficiency, effectiveness, impact, and sustainability.\u003c/p\u003e \u003cp\u003eThe strength of the OECD framework lies in its structured and comparative applicability. By linking programmatic performance to broader societal effects, it extends evaluation beyond narrow resource accounting to assess whether interventions generate durable public value. The inclusion of coherence and sustainability reflects recognition that policy success cannot be measured solely through immediate outputs, but must consider alignment and long-term viability.\u003c/p\u003e \u003cp\u003eHowever, the framework implicitly assumes a relatively stable institutional environment. Coherence is typically treated as one evaluative dimension among others, which is assessing alignment with related policies rather than as a structural condition shaping the feasibility of the policy cycle itself. The IPO architecture presumes that once relevant inputs are efficiently processed, outputs can be translated into durable outcomes within an accommodating institutional context.\u003c/p\u003e \u003cp\u003eIn governance systems characterized by layered constitutional hierarchies and deeply embedded normative orders, this assumption may not hold. When policy inputs derive from external normative frameworks that diverge from foundational legal logics, institutional coherence may condition not merely implementation quality but the capacity of policy outputs to persist over time. This suggests the need to reconceptualize institutional coherence which is not as a subsidiary evaluation criterion, but as a constitutive precondition for policy sustainability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Conceptualizing Policy Sustainability: Durability and Contextualization\u003c/h2\u003e \u003cp\u003ePolicy sustainability extends beyond the survival of legislation. It refers to the long-term durability and adaptive resilience of a policy instrument within evolving political, socio-economic, and normative environments (Jenkins \u0026amp; Patashnik, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Howlett et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Jordan \u0026amp; Moore, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Sustainability therefore reflects a policy\u0026rsquo;s capacity to maintain effectiveness while absorbing systemic shocks (Martikainen, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Within evaluation theory, sustainability is sequentially dependent upon earlier stages of the policy chain: relevance, coherence, and effectiveness collectively shape whether long-term impact can be maintained. Sustainability is thus not an isolated endpoint but the cumulative outcome of institutional alignment.\u003c/p\u003e \u003cp\u003eEmpirical scholarship demonstrates that sustainable policy design requires balancing durability with contextual adaptation. Large-scale policy reforms frequently falter when imported models are insufficiently localized to prevailing institutional and cultural conditions. Without contextual calibration, policy instruments risk generating normative friction that undermines long-term resilience. This insight is particularly salient for outward-looking reforms grounded in international best practices or global normative standards. The long-term viability of such interventions depends on their ability to integrate with domestic constitutional structures and socio-legal traditions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Institutional Coherence as a Structural Precondition\u003c/h2\u003e \u003cp\u003eBuilding upon this sustainability logic, institutional coherence emerges as a foundational structural condition. Institutional coherence refers to the degree of alignment and integration among governance institutions with respect to mandates, rules, and operational logics (Skovgaard, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Coherent systems minimize fragmentation, reduce contradictory policy signals, and provide predictable governance environments that enable durable implementation. The relationship between sustainability and coherence is asymmetrical. While sustainable policies may reinforce institutional stability, coherence must exist at a minimum threshold for sustainability to become attainable. Incoherent institutional environments may generate short-term outputs but remain structurally vulnerable to contestation.\u003c/p\u003e \u003cp\u003eInstitutional coherence operates along two dimensions:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eHorizontal coherence concerns alignment across policy sectors to ensure that reforms in one domain do not undermine legal or administrative frameworks in another (Bolognesi \u0026amp; Pflieger, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eVertical coherence refers to alignment across governance hierarchies from international norms to constitutional provisions and local implementation rules (Breuer et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eIn layered constitutional systems particularly those grounded in religious jurisprudence, the challenge of maintaining vertical coherence becomes especially pronounced. Where imported normative frameworks embody ontological assumptions that diverge from constitutional foundations, institutional misalignment may become structurally embedded rather than administratively correctable.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Institutional Fit and Institutional Acceptance\u003c/h2\u003e \u003cp\u003eWhile coherence provides structural alignment, sustainability also depends on institutional fit and institutional acceptance.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eInstitutional fit refers to the degree to which policy instruments correspond to the social, cultural, and legal systems they seek to regulate (Epstein et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Even formally coherent policies may fail if they lack contextual compatibility with societal norms or implementation capacities. High institutional fit enhances administrative feasibility and reduces friction during execution.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eInstitutional acceptance captures the process through which policy frameworks are socially legitimized and operationally integrated by implementing agencies and affected communities (Cohen et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Acceptance is mediated by trust, perceived legitimacy, and cultural resonance. Policies that threaten deeply embedded values may face resistance, institutional inertia, or judicial contestation.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eInstitutional fit often functions as a catalyst for acceptance. Conversely, weak fit can erode both horizontal and vertical coherence, producing systemic instability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 The Institutional Sustainability Threshold\u003c/h2\u003e \u003cp\u003eTaken together, institutional coherence, institutional fit, and institutional acceptance form a triadic architecture underpinning policy durability.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eCoherence provides structural alignment.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eFit ensures contextual compatibility.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAcceptance supplies legitimacy.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eA deficiency in any one dimension may prevent a policy from crossing what may be termed the Institutional Sustainability Threshold, which is the minimum level of structural and normative alignment required for policy outputs to evolve into durable institutional outcomes.\u003c/p\u003e \u003cp\u003eThis framework is particularly relevant for outward-looking, rights-based legal transplants introduced into governance systems characterized by layered constitutional hierarchies and strong normative foundations.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Methodology","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Research Design\u003c/h2\u003e \u003cp\u003eThis study adopts an interpretivist qualitative research design to examine how institutional coherence, institutional fit, and institutional acceptance shape policy sustainability within constitutionally layered governance systems. An interpretivist orientation is appropriate because the research seeks to understand how institutional actors interpret, negotiate, and contest policy instruments within normative and legal frameworks rather than to test causal relationships through statistical generalization.\u003c/p\u003e \u003cp\u003eThe study\u0026rsquo;s theoretical objective is to extend the OECD IPO evaluation framework by embedding institutional coherence as a structural precondition for policy sustainability. A qualitative design enables in-depth examination of the institutional tensions, stakeholder reasoning, and legal interpretations through which policy instruments interact with embedded constitutional and socio-legal structures. Such dynamics are difficult to capture through purely quantitative indicators.\u003c/p\u003e \u003cp\u003eAnalytically, the study operationalizes the OECD evaluation criteria (relevance, coherence, efficiency, effectiveness, impact, and sustainability) within an extended IPO matrix. Institutional coherence is examined through both vertical dimensions (alignment with constitutional and judicial authority) and horizontal dimensions (cross-sectoral integration across policy domains). Institutional fit is assessed in relation to socio-legal compatibility and administrative capacity, while institutional acceptance is examined through stakeholder perceptions, judicial responses, and institutional adjustments. This analytical structure enables systematic tracing of how policy inputs translate into procedural dynamics and downstream institutional outcomes.\u003c/p\u003e \u003cp\u003eTo clarify the analytical structure of the research, Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e illustrates how the extended IPO framework is operationalized in the empirical analysis. The framework links policy inputs specifically the relevance and institutional coherence of the self-perceived gender identity mechanism to procedural dynamics within the administrative registration process and to downstream outcomes related to effectiveness, impact, and long-term sustainability.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThis analytical framework guided the development of the interview protocol and structured the subsequent thematic analysis of institutional interactions across the policy cycle.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Case Selection\u003c/h2\u003e \u003cp\u003ePakistan\u0026rsquo;s Transgender Persons (Protection of Rights) Act 2018 (TA) was selected as a critical case for examining institutional coherence in policy sustainability. The legislation represents an outward-looking rights-based legal reform influenced by international gender identity frameworks and implemented within a governance system characterized by strong constitutional and religious-legal structures.\u003c/p\u003e \u003cp\u003ePakistan provides significant analytical leverage for studying institutional alignment because its Constitution explicitly mandates conformity with Islamic jurisprudence under Article 227. This provision embeds religious jurisprudence within the constitutional hierarchy, creating a governance structure in which statutory reforms must operate simultaneously within secular administrative procedures and religious legal interpretation.\u003c/p\u003e \u003cp\u003eFollowing case-study methodology (George \u0026amp; Bennett, 2005), Pakistan therefore constitutes a \u0026ldquo;most-likely\u0026rdquo; case in which tensions between internationally derived policy instruments and embedded constitutional norms are expected to become visible. Examining this case enables the study to explore how institutional coherence conditions policy sustainability in governance systems characterized by layered legal authority.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Sampling Strategy and Participants\u003c/h2\u003e \u003cp\u003eTo capture the multi-actor nature of policy processes, the study employs purposive elite sampling structured through a Quadruple Helix framework, which conceptualizes policy ecosystems as interactions among government institutions, academic expertise, professional practice, and civil society (Sharif \u0026amp; Senin, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This framework facilitates the inclusion of perspectives from actors directly involved in the formulation, implementation, interpretation, and societal reception of the TA.\u003c/p\u003e \u003cp\u003eParticipants were selected based on their institutional involvement in policy processes related to transgender legislation, including policy drafting, administrative implementation, professional engagement with gender-related healthcare, or community advocacy. Four participant categories were included:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eGovernment\u003c/b\u003e \u0026ndash; policymakers and administrators involved in drafting the TA and implementing gender registration procedures within the NADRA;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eAcademia\u003c/b\u003e \u0026ndash; scholars specializing in public policy, gender studies, and Islamic jurisprudence;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eProfessional Practice\u003c/b\u003e \u0026ndash; clinical psychologists and medical practitioners working with gender dysphoria and intersex cases;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eCivil Society\u003c/b\u003e \u0026ndash; transgender community representatives, activists, and social workers engaged in community advocacy.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eA total of 14 participants were interviewed, including four government officials, three academic experts, three clinical practitioners, and four civil society representatives. This sample size aligns with qualitative research standards indicating that thematic saturation in expert-based studies typically occurs within 11\u0026ndash;13 interviews (Guest et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). Interviews continued until no substantively new analytical themes emerged.\u003c/p\u003e \u003cp\u003eElite interviewing is widely used in policy research to capture the perspectives of actors engaged in institutional decision-making processes and governance debates (Dexter, 2006), making it particularly suitable for examining contested policy environments involving multiple institutional stakeholders.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Data Collection\u003c/h2\u003e \u003cp\u003eData collection followed a triangulated qualitative design combining documentary analysis and semi-structured elite interviews.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e3.4.1 Documentary Analysis\u003c/h2\u003e \u003cp\u003ePrimary legislative and judicial documents were systematically analyzed to capture institutional interpretations of the policy and its constitutional implications. Key documents included:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ethe Transgender Persons (Protection of Rights) Act 2018;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ethe Transgender Persons (Protection of Rights) Rules 2020;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ethe 2022 recommendations of the Council of Islamic Ideology;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ethe Federal Shariat Court judgment (19 May 2023, Shariat Petition No. 5/1 of 2020).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThese materials were treated as institutional texts reflecting competing normative logics and formal interpretations of constitutional coherence within Pakistan\u0026rsquo;s legal framework.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003e3.4.2 Semi-Structured Interviews\u003c/h2\u003e \u003cp\u003eSemi-structured interviews were conducted using an interview guide aligned with the extended OECD evaluation matrix. Questions explored participants\u0026rsquo; perceptions of policy relevance, procedural integrity, institutional coherence, systemic impacts, and long-term sustainability.\u003c/p\u003e \u003cp\u003eInterviews were conducted between February and May 2023 and lasted between 45 and 90 minutes. With participant consent, interviews were audio-recorded and transcribed verbatim. Interviews were conducted in English or Urdu depending on participant preference. Urdu transcripts were subsequently translated into English prior to coding to ensure analytical consistency while preserving contextual nuance.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Data Analysis\u003c/h2\u003e \u003cp\u003eThe data were analyzed using reflexive thematic analysis (Braun \u0026amp; Clarke, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) supported by NVivo 12 software. The analytical strategy followed an abductive logic, iteratively moving between empirical observations and the conceptual framework to refine theoretical interpretations of institutional coherence and policy sustainability.\u003c/p\u003e \u003cp\u003eThe analysis proceeded through three stages.\u003c/p\u003e \u003cp\u003eFirst, open coding was conducted to identify emergent themes across interview transcripts and documentary sources.\u003c/p\u003e \u003cp\u003eSecond, axial coding connected these themes to the extended IPO criteria and the analytical dimensions of institutional coherence, institutional fit, and institutional acceptance.\u003c/p\u003e \u003cp\u003eThird, selective coding refined core explanatory mechanisms associated with the Institutional Sustainability Threshold, particularly those related to constitutional alignment, procedural safeguards, and stakeholder contestation.\u003c/p\u003e \u003cp\u003eThis layered coding process enabled systematic mapping of institutional tensions onto the extended sustainability framework while remaining open to new patterns emerging from the empirical data.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Validity, Reflexivity, and Ethical Considerations\u003c/h2\u003e \u003cp\u003eSeveral strategies were employed to enhance methodological rigor. First, data triangulation was conducted by comparing interview findings with legislative texts, judicial decisions, and institutional documents. This strengthened the credibility of the analysis by enabling the comparison of stakeholder perspectives with formal institutional interpretations.\u003c/p\u003e \u003cp\u003eSecond, peer debriefing and intercoder validation were undertaken by sharing coded transcripts and thematic matrices with two independent scholars specializing in public policy research. Differences in interpretation were resolved through analytical discussion.\u003c/p\u003e \u003cp\u003eThird, reflexive memoing was maintained throughout the research process to document analytical decisions, trace interpretive development, and minimize potential researcher bias. These procedures enhanced the credibility, dependability, and confirmability of the findings.\u003c/p\u003e \u003cp\u003e Ethical approval for the study was obtained prior to data collection. All participants provided informed consent, and anonymity was ensured through coded identifiers. Interview recordings and transcripts were securely stored and accessible only to the research team.\u003c/p\u003e \u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003e3.6.1 Researcher Positionality\u003c/h2\u003e \u003cp\u003eGiven the interpretive nature of qualitative policy research, it is important to acknowledge the researcher\u0026rsquo;s positionality in relation to the study. The analysis is conducted from a public policy and governance perspective focusing on institutional evaluation rather than normative advocacy regarding gender identity debates. Reflexive memoing and peer debriefing were employed throughout the research process to ensure that interpretations remained grounded in empirical evidence while minimizing the influence of personal normative assumptions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section3\"\u003e \u003ch2\u003e3.6.2 Data Transparency Statement\u003c/h2\u003e \u003cp\u003eIn line with emerging standards for qualitative research transparency, the study documents its methodological procedures and analytical steps in detail. Due to the sensitive nature of elite interviews and the confidentiality agreements established with participants, interview transcripts cannot be publicly disclosed. However, anonymized coding structures, thematic matrices, and documentary sources used in the analysis are available from the author upon reasonable request. All legislative and judicial documents analyzed in the study are publicly accessible through official institutional records.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"4 Research Findings","content":"\u003cp\u003eThe empirical findings are organized according to the extended IPO logic, integrating qualitative data from fourteen participants selected through a Quadruple Helix sampling model (government officials, academics, clinical psychologists, and transgender/intersex individuals) alongside documentary analysis. This structure enables a systematic examination of how stakeholders interpreted the relationship between policy design, institutional coherence, and long-term sustainability.\u003c/p\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Policy Inputs: Institutional Coherence and Institutional Fit\u003c/h2\u003e \u003cp\u003eAt the input stage, the evaluation criteria of relevance, vertical institutional coherence, and institutional fit capture whether the policy\u0026rsquo;s foundational assumptions align with the broader socio-legal environment. The data reveal divergent interpretations among stakeholder groups regarding the relevance and institutional compatibility of self-perceived gender identity as a policy instrument.\u003c/p\u003e \u003cp\u003eFrom the perspective of transgender participants, recognition of self-perceived gender identity was widely described as empowering and socially relevant. Participant NT, a member of the transgender community, stated:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eSelf-perceived identity holds significance in gender change applications, and it should be considered a fundamental right for everyone. People should have the autonomy to self-perceive their gender.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eSimilarly, participant ZN emphasized the psychological significance of legal recognition:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eDue to my mental health and the challenges I faced with gender identity, self-perceived identity offered me the chance to undergo a gender change.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFor these stakeholders, the removal of medical prerequisites was interpreted as enhancing personal autonomy and aligning legal recognition with lived experience. In this sense, several participants suggested that the policy demonstrated strong social relevance for segments of the transgender community.\u003c/p\u003e \u003cp\u003eIn contrast, government officials and academic participants particularly those specializing in Islamic jurisprudence and constitutional law expressed concerns regarding vertical institutional coherence. Participant US observed:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIdentifying or changing one's gender based on self-perceived identity is not allowed as it contradicts Pakistan's Islamic principles, as stated in Article 227.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eParticipant TB similarly noted:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIn Pakistan Islamic law is dominating, so self-perceived identity is not relevant to this legal framework and serious reservations have been shown by stakeholders of society.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eDocument analysis of the 2023 Federal Shariat Court (FSC) judgment reflected comparable reasoning. The Court distinguished between intersex individuals recognized within Islamic jurisprudence on the basis of biological attributes and transgender individuals defined through self-perception. The judgment indicated that Islamic law recognizes gender identity grounded in physical characteristics but does not recognize identity based solely on subjective perception.\u003c/p\u003e \u003cp\u003eThese findings suggest that while the policy input was perceived by some beneficiaries as socially relevant, several institutional actors interpreted the self-perception mechanism as misaligned with the constitutional framework grounded in Islamic jurisprudence. Such perceptions shaped broader debates regarding institutional fit at the foundational stage of the policy cycle.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Procedural Dynamics: Administrative Efficiency and Debates over Procedural Safeguards\u003c/h2\u003e \u003cp\u003eThe process stage of the extended IPO framework evaluates administrative efficiency and procedural integrity. Participants widely acknowledged that the removal of medical gatekeeping improved the accessibility of gender recognition procedures.\u003c/p\u003e \u003cp\u003eParticipant RSK commented:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIt values individuals' free will\u0026hellip; It does not mandate strict requirements like surgery or medical documentation, showing a progressive approach.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eClinical psychologist CP2 similarly observed:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThis methodology prioritizes individuals' autonomy in identifying and validating their gender identity without external medical constraints or mandates.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFrom this perspective, the revised procedures were widely interpreted as administratively efficient and supportive of individual autonomy.\u003c/p\u003e \u003cp\u003eAt the same time, several government officials and legal scholars raised concerns regarding the absence of procedural safeguards and the potential implications for horizontal institutional coherence. One recurring theme involved inheritance law, which distributes shares according to biological sex within Islamic jurisprudence. Participant TB noted:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe major subject to abuse or fraud is the law of inheritance where people can claim more share in wealth after changing their genders.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eParticipant AI further elaborated:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe absence of self-perceived identity regulation can result in fraudulent claims or misrepresentations, disrupting the intended distribution and undermining principles of justice within Islamic inheritance laws.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eWhile participants did not present systematic evidence of widespread abuse, these statements reflect perceived governance risks associated with the absence of verification mechanisms.\u003c/p\u003e \u003cp\u003eParticipants also highlighted cross-sectoral institutional intersections, particularly between civil registration systems and other legal domains. Participant SMH noted:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe current NADRA registration process differs from the previous one, causing inconsistent practices. The new approach doesn't follow standard protocols like using birth certificates, which may lead to a breakdown in the connection with reliable systems.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThese observations suggest that although the policy was widely perceived as procedurally efficient, some institutional actors interpreted the removal of safeguards as introducing administrative ambiguity and potential tensions across interconnected policy domains.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Outputs, Outcomes, and Institutional Implications\u003c/h2\u003e \u003cp\u003eAt the output stage, participants acknowledged that the policy generated measurable administrative results and expanded access to formal documentation.\u003c/p\u003e \u003cp\u003eParticipant ZN stated:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eOn the basis of their gender recognition, they are mainstreamed and socially included in society. Government is working on social and economic assistance such as many transgenders are employed in different government institutions.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFor some community members, legal recognition facilitated access to banking services, voting rights, and employment quotas. In terms of immediate outputs, the policy was widely perceived as achieving its stated objective of simplifying gender registration procedures.\u003c/p\u003e \u003cp\u003eHowever, participants across institutional domains also described a range of downstream implications that they associated with broader institutional tensions.\u003c/p\u003e \u003cp\u003eOne recurring concern involved the legal categorization of intersex (Khunsa) individuals. Several medical and legal participants suggested that the statutory definition of \u0026ldquo;transgender\u0026rdquo; could encompass both biological intersex conditions and self-perceived gender identity. Participant NK, identifying as intersex, explained:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eGender change without birth proof can deny the legal rights of intersex people. Those who are not intersex by birth can change their genders and become intersex person according to the definition of the Act.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eParticipant AI similarly stated:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIntegrating self-perceived identity adds vulnerability to the situation, hindering the achievement of policy goals. Employment benefits may favor binary genders over genuine intersex individuals.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThese observations indicate that some stakeholders perceived the definitional scope of the Act as creating competition over access to benefits or quotas originally intended for biologically intersex persons.\u003c/p\u003e \u003cp\u003eParticipants also referenced broader patterns of societal reception. Participant TB noted that the policy had:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026hellip; the potential to pose challenges to societal and familial structures, as traditional understandings of gender roles and relationships may be impacted.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eSeveral respondents described instances of family or community resistance experienced by individuals who altered their legal gender identity. These narratives suggest that while the policy expanded formal recognition, its social reception varied across communities and institutional settings.\u003c/p\u003e \u003cp\u003eTaken together, these findings illustrate how strong administrative outputs coexisted with perceived cross-sectoral and socio-cultural tensions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Stakeholder Perspectives on Policy Recalibration\u003c/h2\u003e \u003cp\u003eThe findings also reveal differing perspectives regarding possible policy recalibration. Several academic and governmental participants suggested that self-perceived gender identity should not function as the sole legal basis for gender modification.\u003c/p\u003e \u003cp\u003eParticipant CP2 proposed:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eSpecific diagnostic criteria and treatment plans tailored to intersex versus transgender people may be necessary to provide comprehensive, ethical, and effective healthcare to both communities.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eParticipant TB suggested reinstating certain institutional safeguards:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eIntersex persons must be diagnosed through a medical board, but at the same time psychiatric evaluation of transgender must be adopted.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThese views align with recommendations issued by the Council of Islamic Ideology (CII), which emphasize medical verification in cases involving biological ambiguity.\u003c/p\u003e \u003cp\u003eAt the same time, transgender community participants did not uniformly support such recalibration and continued to emphasize autonomy and self-identification as central principles of gender recognition.\u003c/p\u003e \u003cp\u003eTaken together, these perspectives suggest that stakeholders across institutional domains interpreted long-term sustainability as contingent upon recalibrating the balance between individual autonomy, administrative efficiency, and constitutional alignment. Rather than indicating immediate policy failure, these debates highlight how differing interpretations of institutional coherence, institutional fit, and societal acceptance shape assessments of policy viability within a constitutionally layered governance system.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e4.5 Synthesis of the IPO Result Chain: Cognitive Mapping\u003c/h2\u003e \u003cp\u003eTo synthesize the qualitative findings and illustrate the interconnections among emergent themes, a cognitive map was generated using NVivo 12 based on the coded dataset. The figure visually represents the thematic relationships identified across the IPO chain and provides an integrated depiction of how stakeholders interpreted institutional coherence, procedural dynamics, and longer-term policy implications.\u003c/p\u003e \u003cp\u003eAs illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the cognitive map organizes the findings across three primary domains:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eInput-level factors\u003c/b\u003e, including stakeholder interpretations of relevance, vertical institutional coherence, and institutional fit;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eProcess-level dynamics\u003c/b\u003e, particularly administrative efficiency, debates surrounding procedural safeguards, and cross-sectoral institutional intersections;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eOutput-level implications\u003c/b\u003e, including immediate administrative outputs, institutional contestation, and patterns of societal reception.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe visual synthesis highlights how stakeholder interpretations at the input stage were linked to downstream evaluations of administrative integrity and long-term sustainability. Concerns regarding constitutional alignment and definitional scope were thematically connected to cross-sectoral institutional intersections, particularly inheritance law, quota allocation systems, and judicial review processes. Conversely, themes related to autonomy and psychological well-being were linked to positive assessments of procedural accessibility and short-term administrative effectiveness.\u003c/p\u003e \u003cp\u003eImportantly, the cognitive map does not establish linear causality but illustrates patterned associations within the qualitative data. The synthesis suggests that perceptions of institutional coherence and institutional fit at the input stage influenced how stakeholders interpreted subsequent procedural and outcome dimensions. The figure therefore complements the analytical narrative by demonstrating how relevance, coherence, efficiency, and societal reception were thematically interconnected within the extended IPO evaluation framework.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTaken together, the findings illustrate how stakeholder interpretations of relevance, institutional coherence, and procedural safeguards interact across the Input\u0026ndash;Process\u0026ndash;Output chain. While the policy generated notable administrative outputs and expanded formal recognition for some beneficiaries, the data also reveal persistent tensions regarding constitutional alignment, cross-sectoral legal interactions, and societal reception. These dynamics suggest that policy performance cannot be evaluated solely through immediate outputs or administrative efficiency. Instead, the sustainability of the intervention appears contingent upon whether the policy\u0026rsquo;s foundational assumptions remain compatible with the broader institutional architecture in which it operates. This observation provides the empirical basis for the concept of the Institutional Sustainability Threshold, which is further elaborated in the following discussion.\u003c/p\u003e \u003c/div\u003e"},{"header":"5 Discussion: Institutional Coherence and the Sustainability of Legal Transplants","content":"\u003cp\u003eThe empirical findings challenge the assumption that the successful adoption of internationally benchmarked rights frameworks necessarily translates into sustainable domestic governance. Findings from the Pakistani case suggest that policy sustainability is not determined solely by administrative efficiency or output volume, but by the degree of institutional coherence embedded at the input stage of the policy cycle. By extending the OECD IPO evaluation framework, this study highlights how the long-term viability of policy reforms depends on the alignment between policy design and the institutional architecture within which implementation occurs.\u003c/p\u003e \u003cp\u003eMore broadly, the findings contribute to ongoing debates in policy studies concerning the contextualization of policy transfer and legal transplants. While internationally derived norms may offer progressive policy solutions, their sustainability often depends on how effectively they are integrated within existing constitutional, legal, and socio-cultural frameworks. The Pakistani case therefore illustrates how institutional alignment or the lack thereof can shape the trajectory of policy implementation beyond the immediate stage of administrative outputs.\u003c/p\u003e \u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003e5.1 Repositioning Coherence within the IPO Logic\u003c/h2\u003e \u003cp\u003eWithin the conventional OECD evaluation framework, coherence is typically treated as one evaluative criterion among several others, assessed alongside relevance, efficiency, effectiveness, impact, and sustainability. The findings of this study suggest that in constitutionally layered governance systems, coherence may function not merely as an assessment category but as a structural precondition influencing whether policy interventions can generate durable outcomes.\u003c/p\u003e \u003cp\u003eIn the case examined, administrative procedures for gender recognition were widely perceived as efficient and accessible. The removal of medical gatekeeping simplified gender registration and produced measurable administrative outputs. However, the findings also indicate that tensions regarding constitutional alignment emerged early in the policy cycle, particularly among actors responsible for interpreting Islamic jurisprudence and constitutional law. From this perspective, judicial intervention did not appear as an isolated institutional reaction but rather as a manifestation of institutional tensions embedded at the policy\u0026rsquo;s design stage.\u003c/p\u003e \u003cp\u003eThis observation suggests a potential limitation in linear interpretations of the IPO logic, which often assume that effective inputs and efficient processes will naturally lead to sustainable outcomes. Instead, the findings indicate that policy outputs may appear operationally successful while simultaneously generating institutional contestation when foundational inputs remain misaligned with prevailing legal and normative frameworks. This interpretation resonates with institutionalist scholarship emphasizing that policy reforms introduced into dense governance environments are filtered through existing legal structures, organizational routines, and constitutional constraints.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003e5.2 Mechanism: From Normative Misalignment to Institutional Contestation\u003c/h2\u003e \u003cp\u003eThe findings allow the identification of a sequential mechanism linking institutional misalignment to sustainability constraints. This mechanism can be summarized in five stages:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eNormative Input Divergence \u0026ndash; Policy inputs derived from international normative frameworks diverge from entrenched constitutional or legal logics.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eProcedural Vulnerability \u0026ndash; Administrative reforms designed to enhance efficiency reduce procedural safeguards, potentially weakening institutional buffering capacity.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eCross-Sectoral Tension \u0026ndash; Interactions between the new policy instrument and adjacent legal domains\u0026mdash;such as inheritance law, civil registration systems, and welfare allocations\u0026mdash;generate horizontal institutional strain.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eInstitutional Contestation \u0026ndash; Accumulated tensions trigger institutional responses within the governance system, including judicial review or political debate.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSustainability Constraint \u0026ndash; The long-term viability of the policy becomes contingent upon institutional recalibration or structural realignment.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eElements of this sequence were reflected in the empirical findings. Debates over inheritance law, definitional scope, and constitutional compatibility emerged alongside administrative implementation, eventually culminating in judicial scrutiny of the legislation. The mechanism therefore suggests that sustainability in layered governance systems may depend less on output success than on the extent to which policy inputs remain integrated with existing institutional logics.\u003c/p\u003e \u003cp\u003eImportantly, this mechanism does not imply that administrative efficiency is inherently problematic. Rather, it indicates that efficiency gains may accelerate the diffusion of policy instruments whose institutional compatibility remains contested. In such contexts, procedural streamlining may unintentionally amplify institutional tensions by scaling reforms more rapidly than institutional structures can absorb.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003e5.3 The Institutional Sustainability Threshold\u003c/h2\u003e \u003cp\u003eTo conceptualize the relationship between institutional coherence and policy durability, this study advances the concept of the Institutional Sustainability Threshold (IST). The threshold refers to the minimum level of structural and normative alignment required for policy outputs to transition into durable institutional outcomes. It serves as an analytical device for identifying the point at which institutional misalignment begins to generate sustained contestation within a governance system.\u003c/p\u003e \u003cp\u003eUnlike conventional evaluation criteria, which typically assess outcomes after implementation, the Institutional Sustainability Threshold conceptualizes sustainability as conditional upon the compatibility of policy inputs with the broader institutional environment. Within the extended IPO framework, sustainability is therefore not only a downstream outcome but also a function of institutional alignment at earlier stages of the policy cycle.\u003c/p\u003e \u003cp\u003eThe threshold operates across three interrelated dimensions.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFirst, vertical institutional coherence.\u003c/b\u003e \u003c/p\u003e \u003cp\u003ePolicies must align with the hierarchical structure of constitutional authority. In governance systems where constitutional provisions incorporate religious or normative legal frameworks, statutory reforms that diverge from foundational principles may encounter corrective mechanisms such as judicial review. When vertical misalignment exceeds institutional tolerance, sustainability becomes contingent upon constitutional reinterpretation or legislative recalibration.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSecond, horizontal institutional integration.\u003c/b\u003e \u003c/p\u003e \u003cp\u003ePolicies must maintain consistency across sectoral domains. Reforms in civil identification systems intersect with a range of legal and administrative domains, including family law, inheritance structures, welfare allocation, and regulatory regimes governing public spaces. Where cross-sectoral implications are insufficiently coordinated, institutional fragmentation may emerge. Horizontal incoherence may not immediately prevent implementation, but it increases the likelihood of downstream institutional friction.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThird, institutional fit and societal acceptance.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eBeyond formal legal alignment, policy instruments must resonate with prevailing socio-cultural norms and administrative capacities. Institutional fit reduces interpretive ambiguity, while societal acceptance contributes to legitimacy that stabilizes policy implementation. Where such alignment is weak, institutional actors may reinterpret or selectively enforce policy provisions, potentially undermining long-term durability.\u003c/p\u003e \u003cp\u003eThe Institutional Sustainability Threshold is crossed when these dimensions collectively provide sufficient institutional absorptive capacity for the policy instrument. Below the threshold, misalignment accumulates across stages of the policy cycle, increasing the likelihood of institutional contestation. Above it, policy outputs are more likely to become routinized within institutional practice.\u003c/p\u003e \u003cp\u003eCrucially, the threshold is dynamic rather than fixed. Its position varies depending on the rigidity of constitutional hierarchies, the authority of judicial institutions, and the density of socio-cultural embeddedness. In systems characterized by strong constitutional review and deeply entrenched normative orders, the threshold may be comparatively narrow. In more pluralistic institutional environments, governance systems may absorb greater degrees of normative innovation before contestation escalates.\u003c/p\u003e \u003cp\u003eBy conceptualizing sustainability as a function of institutional absorptive capacity, the Institutional Sustainability Threshold extends existing discussions of institutional fit in governance literature. While institutional fit typically focuses on the compatibility between governance arrangements and social contexts, the threshold framework emphasizes the minimum level of alignment required for policy outputs to stabilize within layered institutional systems.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003e5.4 Implications for Evaluation Theory and Policy Transfer\u003c/h2\u003e \u003cp\u003eThe findings contribute to policy evaluation scholarship in three principal ways.\u003c/p\u003e \u003cp\u003eFirst, they reposition institutional coherence from a supplementary evaluative indicator to a constitutive condition within the IPO framework. This reframing shifts attention from retrospective assessments of alignment to proactive examination of structural compatibility during policy design. Second, the analysis highlights the limitations of output-centric evaluation metrics. High administrative throughput may signal short-term effectiveness while masking underlying institutional tensions that undermine long-term sustainability. Third, the study contributes to scholarship on policy transfer and legal transplants, particularly in Global South contexts. Research on policy transfer has long emphasized that imported policy models must adapt to domestic institutional environments. The findings reinforce this insight by demonstrating how the sustainability of rights-based reforms may depend on their compatibility with constitutional structures, legal traditions, and socio-cultural norms.\u003c/p\u003e \u003cp\u003eAlthough illustrated through the Pakistani case, the conceptual framework proposed here may also be relevant for other governance systems characterized by layered legal orders, strong constitutional review mechanisms, or intersections between secular and religious legal frameworks. In such contexts, institutional coherence may play a decisive role in determining whether externally derived policy models can be sustainably integrated into domestic governance structures.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec30\" class=\"Section2\"\u003e \u003ch2\u003e5.5 From Efficiency to Durability\u003c/h2\u003e \u003cp\u003eThe broader theoretical implication of this study is that sustainable governance requires balancing procedural efficiency with institutional compatibility. Administrative streamlining may expand access to recognition, rights, and public services; however, efficiency alone cannot guarantee policy durability if institutional alignment remains contested.\u003c/p\u003e \u003cp\u003eThe Pakistani case illustrates how policy instruments derived from international norms may achieve rapid administrative implementation while simultaneously generating debates regarding constitutional compatibility and institutional fit. These dynamics highlight the importance of embedding policy innovations within existing governance architectures through calibrated procedural safeguards, cross-sectoral coordination, and ongoing institutional dialogue.\u003c/p\u003e \u003cp\u003eViewed through the lens of the Institutional Sustainability Threshold, policy sustainability becomes less a retrospective judgment about outputs and more a question of institutional architecture. Durable governance emerges when policy inputs, procedural design, and societal reception remain sufficiently aligned with the institutional structures within which implementation occurs.\u003c/p\u003e \u003c/div\u003e"},{"header":"6 Conclusion","content":"\u003cp\u003eThis study evaluated Pakistan\u0026rsquo;s Transgender Persons (Protection of Rights) Act 2018 through an extended application of the OECD IPO framework. By embedding institutional coherence as a structural precondition within the evaluation logic, the research demonstrates that policy sustainability cannot be inferred from administrative efficiency or high output volume alone.\u003c/p\u003e \u003cp\u003eThe findings indicate that while the policy effectively expanded access to legal gender recognition and streamlined administrative procedures, tensions at the level of constitutional alignment and cross-sectoral integration constrained its long-term durability. The judicial invalidation of key provisions illustrates how misalignment at the input stage can reverberate across the policy cycle, affecting downstream institutional stability.\u003c/p\u003e \u003cp\u003eThe principal theoretical contribution of this study lies in repositioning institutional coherence from a subsidiary evaluative criterion to a constitutive condition of sustainability within the IPO architecture. In doing so, the article advances the concept of the Institutional Sustainability Threshold, defined as the minimum degree of structural and normative alignment required for policy outputs to evolve into durable institutional outcomes. This conceptual refinement contributes to evaluation theory by foregrounding institutional context as a determinant of long-term policy viability.\u003c/p\u003e \u003cp\u003eThe case further underscores the importance of contextualization in outward-looking legal reforms, particularly within Global South governance systems characterized by layered constitutional hierarchies and embedded normative orders. The findings do not suggest that international rights frameworks are inherently incompatible with such systems. Rather, they demonstrate that sustainable integration requires calibrated adaptation, cross-sectoral coordination, and careful alignment with foundational legal principles.\u003c/p\u003e \u003cp\u003eMore broadly, the study highlights a critical lesson for policy transfer scholarship: high performance in the process and output stages does not guarantee systemic sustainability. Durable governance emerges when normative ambition is matched by institutional coherence.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe research leading to these results received funding from Universiti Teknologi Malaysia through the International Doctoral Fund awarded to support the doctoral research of Hamza Iftikhar.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e \u003cp\u003eThis article builds upon the doctoral research of \u003cem\u003e(name)\u003c/em\u003e conducted at \u003cem\u003e(university name)\u003c/em\u003e. The research was financially supported by the \u003cem\u003e(fund)\u003c/em\u003e. The authors gratefully acknowledge this support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAlam I (2021) Identity crisis and rights in trouble: Transgenders in Islamic Republic of Pakistan. J Political Stud 28(1):55\u0026ndash;72\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBlitt RC (2018) The Organization of Islamic Cooperation\u0026rsquo;s response to sexual orientation and gender identity rights: A challenge to equality and nondiscrimination under international law. Transnatl Law Contemp Probl 28:89\u0026ndash;144\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBolognesi T, Pflieger G (2019) The coherence(s) of institutional resource regimes: Typology and assessments from the case of water supply management. 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Environ Policy Gov 28(5):332\u0026ndash;343. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/eet.1819\u003c/span\u003e\u003cspan address=\"10.1002/eet.1819\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Universiti Teknologi Malaysia","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Policy evaluation, contextualization, OECD Input-Process-Output, Institutional Sustainability Threshold, policy coherence","lastPublishedDoi":"10.21203/rs.3.rs-9216548/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9216548/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eDriven by global human rights movements, states increasingly adopt reforms centered on rights to address the marginalization of vulnerable groups. However, transplanting international normative frameworks into deeply embedded social and legal systems without rigorous contextualization can generate significant policy friction. This article addresses this theoretical gap by extending the Organisation for Economic Cooperation and Development (OECD) Input-Process-Output (IPO) evaluation logic, introducing institutional coherence as a critical precondition for long term policy sustainability. Using the Transgender Persons Protection of Rights Act 2018 in Pakistan as a Global South test case, this qualitative study evaluates the viability of unverified self\u0002perceived gender identity as a policy instrument. Data were collected through systematic document analysis including the 2023 Federal Shariat Court judgment and Council of Islamic Ideology recommendations and guided elite interviews (n = 14) mapped across a Quadruple Helix stakeholder model. Thematic analysis was conducted using NVivo 12. Findings indicate that while the Act maximized administrative efficiency and immediate outputs, as reflected in a rapid increase in legal gender registrations, it generated substantial institutional tensions. Uncontextualized policy inputs intersected with constitutional and religious frameworks, producing normative incoherence. This misalignment contributed to systemic consequences, including inheritance disputes, the marginalization of biological intersex individuals, and institutional contestation. This article extends the OECD IPO evaluation framework by reconceptualizing institutional coherence as a structural precondition for policy sustainability. It introduces the Institutional Sustainability Threshold to explain how institutional alignment determines whether policy outputs can transition into durable outcomes in constitutionally layered governance systems.\u003c/p\u003e","manuscriptTitle":"Institutional Coherence as a Condition for Policy Sustainability: Extending the OECD Input–Process–Output Model in the Context of Pakistan’s Transgender Policy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-26 10:49:33","doi":"10.21203/rs.3.rs-9216548/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a1d9bc06-4512-445d-a714-b3bc4ac3adc1","owner":[],"postedDate":"March 26th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":65080327,"name":"Other Public Policy"}],"tags":[],"updatedAt":"2026-03-26T10:49:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-26 10:49:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9216548","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9216548","identity":"rs-9216548","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}