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The subject of access to gendered public toilets is one which can cause a great deal of distress for trans individuals. Indeed, some people can feel so intimidated by the process, that it can cause them to skip their visit to a public restroom altogether – choosing instead to hold everything in until they get home.


To better understand the impact that this can have on the body we asked Dr Helen Webberley to share her insights:

The bladder is like a bag made of muscle. When it is empty it is small and deflated. As it fills the walls gently stretch and the bag expands. When the muscle fibres have stretched to a certain limit, it starts sending signals that you should have a wee, when convenient. If you do not empty your bladder, the muscle fibres continue to stretch further and the signals get stronger and stronger until the bladder can hold no more and it contracts to expel some of its volume.

Most people can “hold it” anywhere from a couple of hours up to six. However this varies based on a number of factors including the strength of your pelvic floor (both for men and for women) how much your bladder is able to hold, how much fluid you have consumed, whether you are on certain medication and your general overall health. In addition you need to consider how much urine your body is making, which can vary depending on how much you drink and how much you sweat.

Additional factors to be taken into consideration are the effects of hormones on the lining of the urinary tract. People who are taking hormones, or who are deplete in hormones, can find that the desire or need to empty their bladder changes. So trans people may find themselves needing to use the loo more often than they did before their transition.

Having to regularly hold your urine for long periods can weaken the bladder muscles and lead to an increased risk of urinary retention, the inability to empty your bladder completely, causing discomfort and pain.

In general, humans can hold off going to empty their bowels for longer, with some people going for days in between trips to the toilet. But, health-wise, best practice is to go when you need to, not when you are ‘allowed’ to!

Any healthcare professional would advise going to the toilet to empty your bladder or bowels when your body tells you it’s time to do so. Institutions, organisations, public buildings, policies should all allow people to use bathroom facilities according to need rather than ability, or other protected characteristic.

If we take learning from organisations who have fought for equal access for toilet users with disabilities, then we can see clearly that: ‘Under the Equality Act 2010, all organisations have a duty to provide accessible goods and services. The provision of accessible toilet facilities is a fundamental and crucial part of inclusive service delivery, their design and management warrant careful attention.’

Trans women and girls should not have to hold their water because the only alternative available to them is to queue up at the urinals, simply because they have a penis. Being able to use the bathroom is a basic human right.


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If you have been affected by any of the issues raised in this blog post and you would like to speak to a member of the team, visit our Help Centre.


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