There is a huge deficit of toilet provision for women. Photo: Getty
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The politics of sanitation: why we urgently need more public toilets

Elderly people, disabled people, people with carers, women and children all have their lives limited by the UK’s lack of public toilets. We need to talk about this unseen sanitation crisis.

Question: what does everyone do, at least eight times a day?

Give in?

Answer: go to the toilet.

Yet although we all do it, we don’t talk about it. The politics of sanitation is about everything, proclaims Britain’s pioneering toilet campaigner, Prof Clara Greed. Humans do it where they can, anywhere and everywhere: we do it up Mount Everest, all over India’s mighty railways; we poison Rio’s Guarabara Bay – the city says it won’t be able to clean it up in time for the 2016 Olympics; our stuff ends up in “flying toilets” – poo in plastic bags floating in Africa’s Lake Victoria or landing on the rooves and pathways of slums and shanty towns everywhere. A third of the world’s people don’t have access to sustainable sanitation.

Toilets have been debated at parliamentary hearings, contested on college campuses, and toilet agit prop in Chinese cities got feminists arrested this year for “picking quarrels”: they’d occupied the gents to draw attention to the seemingly global phenomenon of queues outside the ladies. 

Toilets are a mark of modernity, they locate the most private needs and dilemmas in the public realm. They are among the first public places encountered by children – toddling along a boulevard, high street, lane, mall or gracht, infant flanneurs suddenly need to go the toilet. It is always sudden. If it is only a wee, then a tree, or a kerb, or a doorway might do, but what if it is not? What if it’s a number two – poo, scheiss, merde, kakka? A child, so small, so desperate, but where to go?

My childhood was punctuated by these dramas. When our little brother just had to go, where could his sisters or his mother could take him? A stinky pissoir in Paris, a krul in Amsterdam, designed only with men in mind? Or England’s underground dungeon designated “gents” or “ladies”.

Toilets have been on my mind ever since. Children’s entry to the public world is choreographed around gendered signs indicating welcome or prohibition.

Now there is a crisis: we are losing our public toilets. A 2008 report from the Communities and Local Government committee, The Provision of Public Toilets, noted that the absence of a legal duty, plus privatisation and cuts produces protracted decline. “This decline needs to be addressed,” said the committee. It is not addressed. 

The doyenne of toilet politics, Prof Clara Greed reckons Britain lost 40 per cent of its public toilets in the decade before the 2010 coalition. Since then, Age UK reports, English cities have lost another 20 per cent. 

Clara Greed, professor of Inclusive Urban Planning at the University of the West of England, ignited a wave of “toiletology” with her book on public toilets in 2003. She describes this loss as an assault on citizens’ rights: toilets are vital to accessible, equal and sustainable cities. “All dimensions of human life are components of the toilet agenda – gender, age, sexuality, ethnicity, class., disability.” She insists that toilets should not be seen as “money down the drain”, not a burden but a benefit.

Ironically, the decline of public toilets has shadowed the rise of global cities and the rise of flourishing nighttime economies and, inevitably, pissed people pissing in the streets.

In Amsterdam, it is estimated that every year a dozen or so men lose their lives whilst “wild plassen” – peeing in the canals. Holland improvised mobile plastic urinals that look like they belong on a Doctor Who set to address the problem of “indiscriminate urination”. A Dutch company, Urilift, invented pop-up toilets – pods connected to underground utilities that rise at night and sink during the day. Urilift commercial director Wim Hermans tells me that pop ups were designed for drinkers, or rather: “Men. I can’t say it more beautifully than that - men are the problem.”

The fate of the public toilet is the antithesis of the nineteenth century urban revolution when pissoirs spread across Paris after Napoleon commissioned Baron Haussman to re-design the capital, and Britain’s 1875 Public Health Act made the provision of public toilets and sanitation an emblem of civic pride. 

But they were always gendered and the beneficiaries were men, says Prof Greed: fewer than half were for women, even though women take longer and have more complex sanitary needs, from undoing clothing to menstruation. She calculates that we need a ratio of two to one in favour of women to create equal access. “Women are likely to outnumber men in ratio of 65 to 35 in shopping areas and up to 80 to 20 in busy shopping malls,” yet in town centres at “best” (in rare instances) provision is likely to be half and half, “and more typically, on a 70 to 30 ratio in favour of men”. Women’s toilet time is compounded by menstruation – a quarter of women may be menstruating at any one time.

Clara Greed explains that the 1936 Public Health Act, which allows (but does not mandate) local authorities to provide public toilets, permitted them to charge fees “other than for urinals”. So, toilets for women were seen as a “special burden”, until the 2010 Equality Act allowed charging both men and women.

Westminster Council was one of the first to introduce pop ups in Britain: it installed temporary urinals and pop ups in the West End. The council has handed over all of its public toilets to a private contractor, but it still has statutory equality duties. Has it performed an equality impact assessment? Has it audited the various needs of women, men, children, able bodied and disabled? Four attempts to get a response from Westminster have yielded no answer.

Why do urinals persist? And why are they so stinky? “Rancid!” says Ray Martin, a toilet enthusiast and director of the British Toilet Association. “Urinals are anathema,” he says. He first started thinking about toilets when he suddenly became a widower 28 years ago, with two young daughters: “I had to take them with me into the gents. That’s what put toilets on my agenda.”

The stink problem is not much men, or even urine, it is the uric acid crystals that loiter in urinals and don’t get sealed off in the alternative toilet s-bend. (Uric acid from promiscuous urinators around Trafalgar Square has apparently eroded some of the National Gallery’s masonry.)

Germany is pioneering a movement to make men sit to pee – stehpinklers v sitzpinklers. Unsurprisingly it met manly resistance which this year was vindicated by a court ruling against a landlord who wanted to withhold part of a tenant’s deposit because of uric acid damage to the marble floor. It was only a partial victory for stehpinklers, however – the judge sympathised with the landlord, but cautioned that tenants should be forewarned.

In the US, the gendering of toilets is inscribed in planning laws, and remains totemic for Republican and religious right ideologies of separate spheres, identities and powers. For a quarter of a century “potty parity” has been promoted by an equalities lawyer with a marvelous monicker, John Banzhaf III, and by architecture professor Kathryn Anthony, whose focus is family-friendly toilets for both men and women, toilets that accommodate carers, and equality based on time as well as quality of space. Anthony’s trigger happened in the last week of her late husband’s life: wheelchair-bound, he needed help, but she could not take him to the men’s room, and he couldn’t go to the women’s room.

The eminent US equalities lawyer Mary Ann Case writes that despite decades of equalities activism, “public toilets are among the very few sex-segregated spaces remaining in our culture” that are governed by law. That’s what led Case into the politics of toilets.

Clara Greed, too, was provoked by both the persistence of segregation and the huge deficit of provision for women. 

Sex separation is idiosyncratic, however: it is most robustly enforced in large public arenas, sports facilities, schools, colleges and shopping arcades and stations, while unisex toilets are universal on planes, trains and, of course, in homes.

One of Britain’s toilet and urban design scholars, Jo Ann Bichard, research fellow at the Royal College of Art, discovered complex relationships to strangers and intimates when she studied women’s use of space and Turkish baths: “We called it naked ethnography,” she says. That took her to toilets. “We allow everyone into private toilets,” says Bichard, but in public buildings and men and women are directed through different doors. “On planes I sit next to a man and think I might die with you! He uses the same toilet as I do.” Yet put Bichard and that man in a college, shopping centre, or cinema and they are steered in different directions. If gender neutral toilets are ok in small places and homes, why not in shops, universities, theatres and the high street? 

Mary Ann Case believes that the “time for integrating toilets has come”. It would “relieve the anxieties” of the transgendered, parents and children, or people who need carers, and it would also detonate the prevailing demand that we all “self-segregate by handing a gendered sign on ourselves”. 

Case resists the idea of women-only toilets as safe spaces – women can be raped anywhere. Clara Greed, however, argues that women still “need their own space”, for good reason some women, particularly the elderly and those who have experience violence, just don’t want to give it up. 

For a decade conflict has been growing on some university campuses in the US over sexed toilets and transgender access to women’s toilets. In Britain, however, there is (with the exception of Brighton) no national transgender toilet strategy, and several prominent transwomen campaigners insisted to me that they experienced no problem of access, “toilet reform? I’ve never even heard it mentioned”, said one trans campaigner, “and I’ve never had a problem”.

But there is a problem and it confronts everyone – exponential decline in public provision. In 2011 Royal College of Art designer Gail Knight (who collaborates with Jo Ann Bichard) launched a public participation website to create The Great British Public Toilet Map. It came out of her work on ageing: next to dementia, incontinence is elderly people’s greatest fear. It is a dread that keeps them stuck at home.

Sanitation – and the lack of it – is an occupational hazard for cabbies, street vendors, truckers, couriers and homeless who, like everyone else, average at least eight visits per day, or about 2,500 per year. Businesswoman Gillian Kemp launched the Truckers Toilets Campaign after overhearing two women drivers discussing the difficulties of finding toilets while on the road: truckers are refused access by clients and some resort to a “bucket and chuck it” approach, and women drivers have to cope with periods, too. “Lorry drivers are not treated with respect,” says Kemp. “We expect 24-hour deliveries, but we don’t think about the needs of the person delivering.”

Like most of the “toileteers”, she advocates a statutory obligation. In 2012 France embarked on a programme of free and adequate public toilets. But not Britain. The former Conservative communities minister, Eric Pickles, refused to support statutory obligation. 

Peter Hampson, director of the British Resorts and Destinations Association, told the Parliamentary committee that public toilets cost local authorities £100m per year, but they earn back a meagre £4.5m in charges. “Frankly, it costs as much as to collect a 20p, cart it, count it, account for it as it does to collect it.”

The solution is obvious, says Clara Greed: make provision a public duty, “more public toilets and more space”. Even disabled toilets – seemingly the apogee – are an illusion of perfection. A decade ago Jo Anne Bichard and her colleague Gail Knight researched 101 disabled cubicles, “Not one followed the regulations,” says Bichard.

“There’s an artificial divide between able and disabled: public toilet design is awful for everybody,”  protests Clara Greed. More people travel in buggies than wheelchairs, and able bodied people have to navigate what she calls a “three-point turn” to get into a narrow cubicle already occupied by a mega toilet roll holder and sanitary bin.

Contemplating what would make toilets accessible to all now confronts not only the need to accommodate “companion carers” but the impact of a global world with diverse manners and rituals: standing vs sitting, sitting vs squatting. Europeans on both sides of the sitting-standing war may think they are sanitation pioneers, but sitting on a toilet is as weird to much of the world’s people as squatting appears to the rest; then there’s and wiping vs washing: to much of the world, wiping with paper rather than washing just seems filthy. 

The best model for all is a mix of gender-specific spaces and safe unisex disabled toilets with baby-changing facilities. Gents may like urinals or the open air, but single cubicles, capacious if not fragrant, work for everybody.

Beatrix Campbell is a writer, broadcaster, campaigner and playwright.
Photo: Getty
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We argue over Charlie Gard, but forget those spending whole lives caring for a disabled child

The everyday misery of care work is hidden behind abstract arguments over life and death.

“Sometimes,” says the mother, “I wish we’d let him go. Or that he’d just been allowed to slip away.” The father agrees, sometimes. So too does the child, who is not a child any more.

On good days, nobody thinks this way, but not all days are good. There have been bright spots during the course of the past four decades, occasional moments of real hope, but now everyone is tired, everyone is old and the mundane work of loving takes a ferocious toll.

When we talk about caring for sick children, we usually mean minors. It’s easiest that way. That for some parents, the exhaustion and intensity of those first days with a newborn never, ever ends – that you can be in your fifties, sixties, seventies, caring for a child in their twenties, thirties, forties – is not something the rest of us want to think about.

It’s hard to romanticise devotion strung out over that many hopeless, sleepless nights. Better to imagine the tragic mother holding on to the infant who still fits in her loving arms, not the son who’s now twice her size, himself edging towards middle-age and the cliff edge that comes when mummy’s no longer around.

Writing on the tragic case of Charlie Gard, the Guardian’s Giles Fraser claims that he would “rain fire on the whole world to hold my child for a day longer”. The Gard case, he argues, has “set the cool rational compassion of judicial judgement and clinical expertise against the passion of parental love”: “Which is why those who have never smelled the specific perfume of Charlie’s neck, those who have never held him tight or wept and prayed over his welfare, are deemed better placed to determine how he is to live and die.”

This may be true. It may also be true that right now, countless parents who have smelled their own child’s specific perfume, held them tightly, wept for them, loved them beyond all measure, are wishing only for that child’s suffering to end. What of their love? What of their reluctance to set the world aflame for one day more? And what of their need for a life of their own, away from the fantasies of those who’ll passionately defend a parent’s right to keep their child alive but won’t be there at 5am, night after night, cleaning out feeding tubes and mopping up shit?

Parental – in particular, maternal – devotion is seen as an endlessly renewable resource. A real parent never gets tired of loving. A real parent never wonders whether actually, all things considered, it might have caused less suffering for a child never to have been born at all. Such thoughts are impermissible, not least because they’re dangerous. Everyone’s life matters. Nonetheless, there are parents who have these thoughts, not because they don’t love their children, but because they do.

Reporting on the Gard case reminds me of the sanitised image we have of what constitutes the life of a parent of a sick child. It’s impossible not to feel enormous compassion for Charlie’s parents. As the mother of a toddler, I know that in a similar situation I’d have been torn apart. It’s not difficult to look at photos of Charlie and imagine one’s own child in his place. All babies are small and helpless; all babies cry out to be held.

But attitudes change as children get older. In the case of my own family, I noticed a real dropping away of support for my parents and disabled brother as the latter moved into adulthood. There were people who briefly picked him up as a kind of project and then, upon realising that there would be no schmaltzy ending to the story, dropped him again. Love and compassion don’t conquer all, patience runs out and dignity is clearly best respected from a distance.

All too often, the everyday misery of care work is hidden behind abstract arguments over who gets the right to decide whether an individual lives or dies. I don’t know any parents who truly want that right. Not only would it be morally untenable, it’s also a misrepresentation of what their struggles really are and mean.

What many parents who remain lifelong carers need is adequate respite support, a space in which to talk honestly, and the recognition that actually, sometimes loving is a grim and hopeless pursuit. Those who romanticise parental love – who, like Fraser, wallow in heroic portrayals of “battling, devoted parents” – do nothing to alleviate the suffering of those whose love mingles with resentment, exhaustion and sheer loneliness.

There are parents out there who, just occasionally, would be willing to set the world on fire to have a day’s respite from loving. But regardless of whether your child lives or dies, love never ends. 

Glosswitch is a feminist mother of three who works in publishing.