It is Time for Bathrooms in Asia and the Pacific to Accommodate People of All Genders

Sexual and gender minorities have special needs in terms of sanitation.
Sexual and gender minorities have special needs in terms of sanitation.

By Alexandra Conroy, Shuvechha Khadka

Sexual and gender minorities, sometimes identified under the umbrella terms SOGIESC and LGBTQI+, have special needs in terms of sanitation. Many of these can be met with some basic actions by governments and the private sector in Asia and the Pacific.

During our research in Nepal, we came across the heartbreaking story of a 23-year-old transgender person, from the small town of Kakarbhitta, who was assigned male at birth but identifies as a woman. 

She spoke of being stopped by attendants from using the female toilets at schools, hospitals and restaurants. This led to her waiting, sometimes many hours, until she returned home to use the bathroom. Tragically, this resulted in a severe kidney infection on one occasion.

Sadly, this story didn’t surprise us at all. We have encountered similar accounts about the impact of poor sanitation in Asia and the Pacific’s developing countries, often affecting some of the region’s most vulnerable groups. 

Sanitation, which many people take for granted, can be a serious challenge for sexual and gender minorities, sometimes identified under the umbrella terms SOGIESC (sexual orientation, gender identity and expression, and sex characteristics) and LGBTQI+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual and gender minorities). 

Many women avoid drinking too much water when making road trips in certain regions because they know it will be difficult finding a toilet on the way, let alone a clean and functioning one. The fear of verbal and physical harassment, simply for needing to use a toilet that aligns with one’s gender identity and basic needs, would be like adding insult to injury.

Among developing countries in Asia and the Pacific, Nepal is quite progressive in gender and social inclusion – it has recognized and decriminalized same-sex relationships, and implemented policies for sexual and gender minorities. A third sex option, "Others," was included in the 2021 census, to count the total number of persons from sexual and gender minorities at the household level.

However,  when accessing essential services like sanitation, sexual and gender minorities face continued challenges, mainly because of discrimination and stereotyping against them but also because of the lack of inclusive infrastructure. 

What can be done to ensure sexual and gender minorities will no longer lose opportunities for education, work, and participation in society due to a lack of inclusive sanitation?

We need to educate ourselves, and be brave to broach the topics that some might label as too difficult, or outside their direct area of expertise. This often starts with getting a dialogue going, whether among the development community or beyond. Ideally it should involve engaging with people who identify as having a diverse sexual or gender identity, where there is an opportunity through our work or even through our personal lives.

The voice of sexual and gender minorities needs to be heard. This requires ensuring they have a platform and an active role in decisions that affect them, from the planning stage to the design and implementation of projects and initiatives to improve sanitation.

All-gender bathrooms – alongside female and male-only bathrooms – can reduce waiting times for everyone.

While consultation is essential for finding the right solutions, some additional steps to consider include the provision of all-gender toilets in addition to female and male-only facilities in schools, workplaces and public facilities such as transport hubs. 

Providing bins for the disposal of sanitary items in toilets need to be encouraged, even in male washrooms, because some men with diverse sexual and gender identities menstruate. And while we’re discussing the management of sanitary waste as a critical component of inclusive sanitation, why not consider the provision for nappy (diaper) bins and baby change facilities in men’s and all-gender bathrooms, noting it isn’t only women who change babies’ nappies. These steps will minimize health and safety risks for all toilet users and help avoid sewer blockages due to sanitary materials being flushed down the toilet. 

 Signage for inclusive toilets should clearly indicate that people are welcome to use the restroom that best aligns with their gender identity. Alternatively (and perhaps an even simpler solution), signage should emphasize not who can use a bathroom, but what is in a restroom – such as a toilet, urinal, or baby change facilities. 

At the same time, efforts may be needed to sensitize toilet attendants and citizens in general to better enable transgender and non-binary people to access facilities matching their gender identity without fear of harassment or discrimination. A further critical step involves ensuring that toilets are clean, functioning and well-maintained so that all citizens are willing and comfortable to use them.

By taking these steps, the clear economic benefits of sanitation access for sexual and gender minorities can be realized.  Sanitation underpins public health, and appropriate facilities in schools contribute to better education outcomes for boys and girls. Sanitation for all also contributes to increased productivity, economic diversification, and income equality.   

And keep in mind, all-gender bathrooms – alongside female and male-only bathrooms – can reduce waiting times for everyone. And who wants to spend any more time than necessary queuing for the bathroom?

 For Asia and the Pacific’s sexual and gender minorities, a simple trip to the bathroom can be a harrowing and humiliating experience. With the right policies, governments can go far toward improving this situation for some of their most vulnerable citizens.

Research for this blog post was contributed by Seema Rajouria and Andrés Hueso González, of WaterAid.