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I'm not sure this has the same meaning as the Japanese original. I am unfamiliar with the expression 'stand on ceremony', but the Japanese expression means that someone is 'pig-headed' or obstinate.
I also don't think the other English translation is accurate either, as the Japanese doesn't necessarily imply stupidity - rather someone being too stubborn.
from Collins dictionary:
stand on ceremony - to insist on or act with excessive formality
I think if someone insists on something we can call him 頭が固い though in this particular case (頭が固い -> stand on ceremony) it maybe not a good choice.
As for [#1762636], I really doubt that 本当に頭が固い can mean "real idiot".