Public bathrooms are terrible. What will it take to fix them?

Inside one man’s journey to find a way for people to pee in peace.

Public bathrooms are terrible. What will it take to fix them?

Inside one man’s journey to find a way for people to pee in peace.

When he was in the fifth grade, some boys started teasing Steven Soifer in a school restroom. They jostled him while he stood at a urinal, trying to see how he was peeing and rag on him for it. Soifer tried to retreat to a toilet. But the boys kept after him, banging on the flimsy stall door so hard he expected it to break in.

That was the moment Soifer believes he started developing paruresis, a form of social anxiety that affects some 20 million (mostly male) Americans. Paruresis is complex, but basically when sufferers feel they don’t have enough privacy in a restroom, they get into their own heads, worrying about being observed and judged for how they urinate, or for the fact that they can’t let loose a stream on demand. This stress shuts down their urethral sphincter, preventing them from relieving themselves even if they’re about to burst. About 10 percent of sufferers feel this so acutely that it severely limits their ability to go out in public; some sufferers avoid drinking liquids until they suffer dehydration while others hold it until they suffer kidney damage.

After decades struggling with the condition, Soifer became a leading expert on paruresis and in 1996 created the International Paruresis Association (IPA). For the next nine years, he and the IPA focused on helping those with the condition find each other and learn tactics to manage their anxiety and pee relatively freely even in the exposed conditions of American multi-user restrooms. Commonly known to architects as “gang toilets,” these bathrooms have flimsy and incomplete stall and urinal dividers, horrific acoustics, and all too often long, pressuring lines. “But the more I would talk to people and do workshops and see where people were comfortable peeing and not,” said Soifer, “I started to see, well, jeez, if you have well-designed public bathrooms, it’s easier for people with paruresis to use them.” For Soifer, well-designed would mean more private and secure facilities in which most paruretics would not feel so exposed and observed.

He also realized that paruretics were hardly the only people who had a problem with American gang toilets. At least 25 percent of the population, he estimates, take issue with their lackluster design. A 2012 sociological study on public bathroom usage and behavior revealed that men especially find such spaces “nightmarish,” primarily because of their lack of privacy. They have developed entire bathroom-specific social norms, like acceptable standing distances at urinals and eye contact management, to handle their low-key anxieties. For some, these behaviors are little more than vaguely homophobic performance, reinforcing a laughably rigid and explicit straight masculinity. But for many, they reflect real and paralyzing stress that is not so easy to laugh off.

In 2005, Soifer co-founded the American Restroom Association (ARA), a confederation of paruretics and others fed up with the state of American gang toilets who jointly advocate for, among other things, the development and proliferation of new, more private and secure restroom designs. The ARA’s proposal is to replace traditional facilities with rows of fully enclosed, single-use toilet stall-rooms along a corridor, each with its own sink and mirror. Many other designers have independently developed similar proposals for restroom redesigns over time. It is not hard to see why. These plans are a simple, direct answer to widespread problems of privacy and comfort in American multi-user restrooms.

But perhaps more than that, as Soifer recently suggested to me, they could serve not just paruretics and others anxious about bathroom privacy, but other populations with greater needs as well. Fully separate and secure, these stall rooms could all be made unisex with no, or at least limited, public outcry, so long as they were sold as a neutral and practical solution for general privacy and accessibility. They would just become mini versions of modern “family rooms.” This would make life easier for parents or caregivers who need to take charges of the opposite sex into the restroom, as well as for trans people who face serious risks of legal or physical harm when choosing which gendered toilet to use in much of the U.S.

To be clear, not every trans person wants to resolve bathroom debates by making all restrooms gender-neutral. Many want to use the gender-segregated space they prefer. But gender-neutral toilets are an increasingly common and practical way for designers to address gender diversity. Shepherding this design change along as a privacy and comfort boost for powerful social groups, like cis men who feel anxious peeing in gang toilets, could bypass the political acrimony that calls for trans accommodation especially often lead to, while also creating broad social benefits.

But even by selling their common sense plan for toilet redesign as a boost in privacy that would help much of the widely discontented public, especially men, Soifer admits that they have made little headway in getting major builders’ and design groups onboard. What do their struggles bode for groups making arguments for similar overhauls to prevailing gang toilet designs based on gender diversity and social justice, rather than the comfort of powerful cis men’s penises and bladders?

The resistance to change is especially puzzling from a historical perspective, as some of America’s earliest sewer-linked, indoor public restroom configurations actually looked a lot like what they’re proposing, as trans rights lawyer turned toilet historian Terry Kogan noted. He pointed to Boston’s Tremont House Hotel, which opened in 1829. Widely considered the first modern American hotel, and hailed at the time for the luxury and sophistication of its plumbing, it was a major influence on 19th century American design. It also, Kogan pointed out, employed fully enclosed, unisex toilet stall-rooms along public corridors. (And this despite the fact that the Tremont was designed for use by both sexes, but was otherwise obsessed with “protecting women” via gender segregation.)

This approach, which basically just moved older unisex outhouse designs indoors, faded only decades later. According to Kogan’s research, the shift seemingly started with Philadelphia’s Continental Hotel, another influential structure for the era, which went up in 1860. Builders there got the bright idea to cluster toilets in a line in one room so they could all feed into one streamlined sewer pipe. With toilets in close proximity to each other, and Victorian gender segregation norms in full swing, the Continental gendered its new gang toilet rooms — and its few single-user stall rooms. From then on, Kogan believes, hotels using similarly efficient toilet lines decided to use minimal partitions between those toilets as well. Prevailing social ideologies insisted that “men aren’t worried about being seen by other men and women aren’t worried about being seen by women,” he said.

The natural conclusion from this history is that minimally private gang toilet designs have held on ever since because they make more financial sense. Estimates based on some proposals for corridors of gender neutral, single-user, fully enclosed stall rooms do show that they could cost up to three times as much as equivalent gang toilets upfront and require more labor to clean.

But much of that cost comes down to putting a sink and attendant plumbing, ventilation, and safety or emergency equipment in every enclosed stall-room along the corridor. Compromise designs cut down on these costs by putting communal sinks in the corridor rather than in every stall, or by keeping the bottom of the door slightly raised to reduce ventilation needs. Barring such expenses, these rooms could be cheaper to build than gang toilets, using drywall and insulation rather than pricey steel partitions. They may even eat up less valuable floor space, using extant corridors as a waiting area rather than building a large gang toilet milling zone.

The real problem every expert I’ve spoken to believes holds back American toilet redesign efforts like the ARA’s is almost comically simple: We just don’t think enough about restrooms.

These new designs could also offer economic efficiency gains. Rather than closing down an entire gang toilet for cleaning, businesses could close one stall at a time. And rather than forcing one gender to face long lines when gender ratios switched around in a given public space, unisex enclosures could serve any gender mixture with equal ability. This would likely benefit women especially, who still face a shortage of restrooms relative to their needs in buildings that have not done a good job renovating their formerly gendered spaces to accommodate them.

Women might also benefit from the abolition of an all-male space, said Mary Anne Case, who studies the laws and cultural forces around toilet design. “For a lot of American businesses,” she argued, “the men’s room is the holdover of what used to be called the executive washroom” — just divided by gender, not class. Men can use these spaces, she added, to network with majority male power holders and accelerate their careers in ways women cannot.

Then, of course, there’s just the economic benefit of giving people the comfort many of them crave. Jens Rothausen-Vange, an expert on restroom design at the design and architecture firm Alliiance, noted that a number of airports he’s worked with over the past few years have expressed an interest in single user, gender-neutral stalls along corridors because they believe people care enough about airport restroom conditions that they might be able to score more business by making people feel more comfortable using their hub. “As people are trying this,” Rothausen-Vange said of the few businesses that have taken the plunge into radical restroom redesign, “they’re realizing, ‘oh, this isn’t as expensive or hard to maintain as we thought.’”

Some bathroom redesign advocates suspect that legal frameworks, rather than economics, hold developments back. Until recently the international codes that municipalities often use as a template for local ordinances have (in a well-intentioned move to ensure gender potty parity) required a certain number of sex-specific toilet fixtures in every building.

But the ARA and other organizations have had success making logical, economic arguments to code organizations. As of 2018, their efforts have freshly overturned that rule, which means that within 10 or 20 years most municipalities should make no legal fuss about entirely gender neutral facilities either. Code organizations haven’t been as eager to require fully enclosed stalls, conceded Soifer. But they’re no longer actively creating barriers to these new design visions.

Security concerns have, in the past, hampered attempts to increase privacy in American toilets. Cops seem to worry fully enclosed stalls may abet vandalism, public sex and prostitution, drug use, and overdoses. But this is not an insurmountable barrier, either. In 2012, Portland, Oregon, launched the Portland Loo, a single-user, fully enclosed public toilet design. It incorporated slanted vents at the top and bottom of the stall to allow police visibility if necessary, blue lights that prevented intravenous drug users from finding their veins, and graffiti-proof paint, among other seamless security features. These toilets are expensive, but popular and are proliferating across the U.S. despite their cost.

The ideal public toilet.

The ideal public toilet.

The real problem every expert I’ve spoken to believes holds back American toilet redesign efforts like the ARA’s is almost comically simple: We just don’t think enough about restrooms.

Some of this lack of consideration stems from the general human habit of accepting age and ubiquity as proofs of functionality. This is especially true in architecture, said Stephen Cassell, who helped develop gender-neutral restrooms for a high-profile LGBTQ-facing synagogue in Manhattan, Congregation Beit Simchat Torah. These disciplines accept the functionality of gang toilet designs so much that “probably the most cookie-cutter part of any design is bathrooms.”

However, some of this lack of consideration stems from our discomfort talking about what goes on in toilets. Building committees still snigger openly at times when talking about restrooms. And designers and architects usually shunt restroom considerations to the last moment, giving them to the most junior member of a team along with other embarrassing grunt work. “You hear horror stories of designs that didn’t even bother including toilets,” said Case, “let alone enough or a careful consideration of where they were placed and how they were designed to maximize user happiness or efficiency.”

So long as American culture does not take restrooms seriously, ARA’s active membership will remain small, as Soifer admitted it is. A tiny group talking to a disinterested public accomplishes little.

In 2015, Kogan, alongside architect Joel Sanders and trans historian Susan Stryker, founded a project called Stalled! to address American society’s chronic lack of serious restroom analysis. Although created as a direct response specifically to trans restroom debates that were heating up in 2014 and 2015, Stalled!’s overarching goal is to get people thinking critically about restroom design. Sanders claims the project has had a great deal of success. In their workshops, lectures, interviews, and other outreach efforts, he says, they find that they can get all manner of people to engage in serious conversations on restroom design. In the process, he adds, many of them wind up embracing gender neutral, fully enclosed single-user stall room designs, like those Stalled! supports, as the most logical solution for a wide range of people’s bathroom needs. But this initiative too can only slowly chip away at a monstrously entrenched socio-cultural mindset.

“I just see this as a century-long perspective.”
Steven Stoifer, bathroom rights activist

Ultimately, Soifer suspects it won’t be his work that gets the American public to think seriously about toilet redesign, but trans activism. Soifer acknowledged that early in the ARA’s history, he feared embracing trans toilet concerns as part of its mission would alienate potential allies and hurt the bathroom redesign cause. But now, he believes that the furor over trans access to bathrooms has struck profound chords, forcing individuals across the nation to take restrooms seriously as cultural sites, and to discuss them more openly and meaningfully than ever before. Trans activists also have more at stake, and so likely mobilize more efficiently and with greater support from established rights groups, than paruretics who can usually find some kind of accommodation or personal fix for their restroom design discomfort.

Of course, this attention doesn’t mean that America will broadly recognize trans needs and rights anytime soon. But increased public discussion of the meaning of toilets as cultural institutions could coincide with other, more politically benign forces. Rothausen-Vange holds that retiring Baby Boomers will likely soon need caregivers, potentially of another gender, to help them into public restrooms more often, among other disability accommodations. Millennials and Generation Z-ers also seem much more invested in privacy than past generations, notes Kogan, although he’s not sure why that is yet. (Kogan suspects this reflects a growing awareness of the ubiquity and outward undetectability of queerness and an increasing self-consciousness about being seen naked or partially clothed by someone who desires them. Some of his colleagues, he says, just believe it’s a reflection of the intrusion of internet culture into people’s lives, which leads to a search for new bastions of privacy and personal security.) Both generations, aging in a cultural space that takes restroom design seriously, could more effectively agitate for design change.

Even if our culture is shifting towards more engagement with alternative restroom designs, a certain degree of inertia, the standard lethargy of regulatory change, and America’s habit of exempting old buildings from retrofits as long as possible mean it will likely do so slowly. Soifer actually expects to see his ideally private toilet systems spread more quickly in China than America, as officials there are reconsidering toilet norms while also taking active steps to mass-overhaul decrepit or insufficient facilities nationwide. “But I do believe we are moving in that direction as a society,” he said. “I just see this as a century-long perspective.” Entrenched views and social norms crumble slowly, especially around taboo topics like urination and defecation. Still, they do crumble, with the right triggering and reframing debates and mass activism. As Soifer said, “it’s just a matter of time.”


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Mark Hay is a freelance writer, covering food, politics, and sex. His writings have appeared in publications from Aeon to VICE. He previously wrote about cheese regulation for The Outline.