diff --git a/src/Compilers/CSharp/Test/Semantic/Semantics/NullableReferenceTypesTests.cs b/src/Compilers/CSharp/Test/Semantic/Semantics/NullableReferenceTypesTests.cs
index e99825a728b33..fed56e7dc92a4 100644
--- a/src/Compilers/CSharp/Test/Semantic/Semantics/NullableReferenceTypesTests.cs
+++ b/src/Compilers/CSharp/Test/Semantic/Semantics/NullableReferenceTypesTests.cs
@@ -114115,5 +114115,77 @@ public Base(bool b) {}
                 //     Program(int x) : base((T() || M<string?>(out string? s6)) && s6.Length > 1) {} // 7
                 Diagnostic(ErrorCode.WRN_NullReferenceReceiver, "s6").WithLocation(48, 66));
         }
+
+        [Fact]
+        [WorkItem(38183, "https://github.com/dotnet/roslyn/issues/38183")]
+        public void UnboundGenericTypeReference_StructConstraint()
+        {
+            var source =
+@"class Program
+{
+    static void Main(string[] args)
+    {
+        F<Boxed<int>>();
+    }
+
+    static void F<T>()
+    {
+        if (typeof(T).GetGenericTypeDefinition() == typeof(Boxed<>))
+        {
+        }
+    }
+}
+
+class Boxed<T>
+    where T : struct
+{
+    public bool Equals(Boxed<T>? other) =>
+        false;
+
+    public override bool Equals(object? obj) =>
+        Equals(obj as Boxed<T>);
+
+    public override int GetHashCode() =>
+        0;
+}";
+            var comp = CreateCompilation(source, options: WithNonNullTypesTrue(TestOptions.ReleaseExe));
+            CompileAndVerify(comp, expectedOutput: "");
+        }
+
+        [Fact]
+        [WorkItem(38183, "https://github.com/dotnet/roslyn/issues/38183")]
+        public void UnboundGenericTypeReference_ClassConstraint()
+        {
+            var source =
+@"class Program
+{
+    static void Main(string[] args)
+    {
+        F<Boxed<object>>();
+    }
+
+    static void F<T>()
+    {
+        if (typeof(T).GetGenericTypeDefinition() == typeof(Boxed<>))
+        {
+        }
+    }
+}
+
+class Boxed<T>
+    where T : class
+{
+    public bool Equals(Boxed<T>? other) =>
+        false;
+
+    public override bool Equals(object? obj) =>
+        Equals(obj as Boxed<T>);
+
+    public override int GetHashCode() =>
+        0;
+}";
+            var comp = CreateCompilation(source, options: WithNonNullTypesTrue(TestOptions.ReleaseExe));
+            CompileAndVerify(comp, expectedOutput: "");
+        }
     }
 }
diff --git a/src/Compilers/Core/Portable/CodeGen/TokenMap.cs b/src/Compilers/Core/Portable/CodeGen/TokenMap.cs
index c4588f678af63..c02730df23790 100644
--- a/src/Compilers/Core/Portable/CodeGen/TokenMap.cs
+++ b/src/Compilers/Core/Portable/CodeGen/TokenMap.cs
@@ -3,11 +3,7 @@
 using System;
 using System.Collections.Concurrent;
 using System.Collections.Generic;
-using System.Diagnostics;
-using System.Runtime.CompilerServices;
-using System.Threading;
 using Microsoft.CodeAnalysis.PooledObjects;
-using Microsoft.CodeAnalysis.Text;
 using Roslyn.Utilities;
 
 namespace Microsoft.CodeAnalysis.CodeGen
@@ -25,9 +21,14 @@ internal sealed class TokenMap<T> where T : class
     {
         private readonly ConcurrentDictionary<T, uint> _itemIdentityToToken = new ConcurrentDictionary<T, uint>(ReferenceEqualityComparer.Instance);
 
-        private readonly Dictionary<T, uint> _itemToToken = new Dictionary<T, uint>();
+        private readonly Dictionary<T, uint> _itemToToken;
         private readonly ArrayBuilder<T> _items = new ArrayBuilder<T>();
 
+        internal TokenMap(IEqualityComparer<T> comparer)
+        {
+            _itemToToken = new Dictionary<T, uint>(comparer);
+        }
+
         public uint GetOrAddTokenFor(T item, out bool referenceAdded)
         {
             uint tmp;
diff --git a/src/Compilers/Core/Portable/Emit/CommonPEModuleBuilder.cs b/src/Compilers/Core/Portable/Emit/CommonPEModuleBuilder.cs
index f3b74224ef3e8..e189afa01b5ab 100644
--- a/src/Compilers/Core/Portable/Emit/CommonPEModuleBuilder.cs
+++ b/src/Compilers/Core/Portable/Emit/CommonPEModuleBuilder.cs
@@ -30,7 +30,7 @@ internal abstract class CommonPEModuleBuilder : Cci.IUnit, Cci.IModuleReference
         internal Cci.IMethodReference DebugEntryPoint;
 
         private readonly ConcurrentDictionary<IMethodSymbol, Cci.IMethodBody> _methodBodyMap;
-        private readonly TokenMap<Cci.IReference> _referencesInILMap = new TokenMap<Cci.IReference>();
+        private readonly TokenMap<Cci.IReference> _referencesInILMap = new TokenMap<Cci.IReference>(MetadataEntityReferenceComparer.ConsiderEverything);
         private readonly ItemTokenMap<string> _stringsInILMap = new ItemTokenMap<string>();
         private readonly ItemTokenMap<Cci.DebugSourceDocument> _sourceDocumentsInILMap = new ItemTokenMap<Cci.DebugSourceDocument>();
 
diff --git a/src/Compilers/Core/Portable/Emit/MetadataEntityReferenceComparer.cs b/src/Compilers/Core/Portable/Emit/MetadataEntityReferenceComparer.cs
new file mode 100644
index 0000000000000..3cbe08d1960f9
--- /dev/null
+++ b/src/Compilers/Core/Portable/Emit/MetadataEntityReferenceComparer.cs
@@ -0,0 +1,44 @@
+// Copyright (c) Microsoft.  All Rights Reserved.  Licensed under the Apache License, Version 2.0.  See License.txt in the project root for license information.
+
+using System.Collections.Generic;
+using Microsoft.CodeAnalysis.Symbols;
+
+namespace Microsoft.CodeAnalysis.Emit
+{
+    internal sealed class MetadataEntityReferenceComparer : IEqualityComparer<Cci.IReference>
+    {
+        internal static readonly MetadataEntityReferenceComparer ConsiderEverything = new MetadataEntityReferenceComparer(TypeCompareKind.ConsiderEverything);
+
+        private readonly TypeCompareKind _compareKind;
+
+        private MetadataEntityReferenceComparer(TypeCompareKind compareKind)
+        {
+            _compareKind = compareKind;
+        }
+
+        public bool Equals(Cci.IReference x, Cci.IReference y)
+        {
+            if (x is null)
+            {
+                return y is null;
+            }
+            else if (ReferenceEquals(x, y))
+            {
+                return true;
+            }
+            else if (x is ISymbolInternal sx && y is ISymbolInternal sy)
+            {
+                return sx.Equals(sy, _compareKind);
+            }
+            else
+            {
+                return x.Equals(y);
+            }
+        }
+
+        public int GetHashCode(Cci.IReference obj)
+        {
+            return obj?.GetHashCode() ?? 0;
+        }
+    }
+}