When a visiting friend asked if I wanted to go on a run in Philadelphia, I did a lot of planning. Not just our route, but where to go to the bathroom. It did not go well.
I took the rapid-transit PATCO Speedline, which doesn’t have bathrooms on trains. The station I left from in Southern New Jersey didn’t have one either, nor did the one where I arrived in Philadelphia. When I arrived at my friend’s hotel, the lobby’s bathrooms were locked.
Fortunately, I was able to follow a woman with a passcode into the bathroom. But that was a matter of luck. Relying on whims of fate was my only option because the United States — and much of the world — has a public bathroom problem.
On average, the United States has only eight public toilets per 100,000 people, according to the Public Toilet Index, a 2021 report by the British company QS Bathrooms Supplies. That’s far behind Iceland, the country with the highest density of public bathrooms: 56 per 100,000 people. That number drops to four per 100,000 in New York City. Madison, Wis., led the way for U.S. cities, with 35 per 100,000.
It wasn’t always this way. In the 18th century, before indoor plumbing, bathrooms were common and generally communal, said Debbie Miller, a museum curator at Independence National Historical Park. In Philadelphia, one such octagonal outdoor toilet was located in a public garden behind what’s now known as Independence Hall. “You could have shared the privy with George Washington,” she said.
The acceptance of public and shared bathrooms shifted during the Victorian era, Ms. Miller said, when bodily functions became more taboo. The temperance movement to limit alcohol consumption led cities to build public restrooms in the late 1800s and early 1900s: The thinking went that men wouldn’t need to enter a bar to use the bathroom. In the 1930s, investment through the Works Progress Administration and Civil Works Administration added more than two million latrines in parks, on public lands and in rural areas, as well as “comfort stations” in cities, including in Central Park.
But as city budgets dried up in the 1970s, so did resources for maintenance. Movements arose to end the practice of paid toilets, which was seen as both sexist (urinals were often free to use but stalls were not) and classist. Cities responded by removing public toilets altogether.
Bathrooms are “challenging spaces because they end up being, not infrequently, the places where people get needs met that they can’t meet anywhere else,” like sex work, drug use or sleeping, said Lezlie Lowe, the author of “No Place to Go: How Public Toilets Fail Our Private Needs.” “All of these are social concerns that have nothing to do with bathrooms, but because of the nature of those spaces, bathrooms end up being used for people to meet their needs, whether it’s dependency or desperation.”
As public restrooms closed, establishments like coffee shops, museums, libraries and department stores — which are generally open only during certain hours — had to become gatekeepers of restroom access.
“We’re faced with an issue where the demand for public restrooms far exceeds the supply,” said Steven Soifer, the president of the American Restroom Association, a group that advocates better public restrooms. “This gets into, who is responsible for providing public bathrooms?”
There have been various approaches to answering that question. Some European cities have tried public-private partnerships, said Katherine Webber, an Australian social planning researcher who traveled the world in 2018 to study toilets with a grant from the Churchill Fellowship. She said the strongest programs involved local governments playing a role in determining best toilet locations. “A city or a place is going to be doing it better if they’re considering the different needs of both the residents and tourists.”
In 2022, Berlin completed a public toilet expansion, which doubled the number of public restrooms from 256 to 418. The city looked at their existing toilets and identified where the gaps were — then partnered with Wall GmbH, a street furniture company that also builds structures like bus shelters and newsstands.
The same year, London introduced the Community Toilet Scheme, where shops and restaurants could list their toilets as open to the public on the City of London’s website in exchange for a small fee. Business owners believed that window signs advertising restrooms would bring in customers.
Each of these approaches has drawbacks, though: The Berlin toilets cost 50 cents per use, and the London Community Toilet Scheme is only useful during the open hours of the businesses opting in.
Some cities have adopted French “pissoirs” — essentially completely or semiprivate public urinals, which have been around since the early 19th century. In 2011, Victoria, B.C., installed urinals that doubled as street art, called Kros urinals, which have four spots per unit and can also be moved to special events or bars.
But like the classic pissoir, they are typically only usable by people without disabilities and those who can easily use the bathroom while standing. “They’re solving a tiny problem for people who already have pretty good access,” Ms. Lowe said.
Asian countries have taken a different approach, in part because of different cultural norms. Whereas Americans might approach public restrooms with trepidation because of past experiences with dirty or broken facilities, in China, Japan and Singapore, they expect their bathrooms to be clean, said Jack Sim, the founder of the World Toilet Organization. Between 2015 and 2017, more than 68,000 toilets were built in China in what became known as the “Toilet Revolution,” with a directive from the government to keep toilets clean.
Tokyo turned its toilet program into public art. The Nippon Foundation sponsored the redesign of 17 toilets in the Shibuya ward, with striking designs, including a white hemisphere and glass walls that turn from clear to opaque when the bathroom door is locked. They will be cleaned and maintained through partnerships with the Nippon Foundation, the Shibuya City government and the Shibuya City Tourism Association. (A looming question is whether it can be scaled up to cover the large sprawling city.)
American governments have been trying a patchwork of solutions. Some cities have had more success than others, though no one has conquered the problem. In 2008, New York City bought 20 self-cleaning toilets that cost 25 cents per use. But installing them stalled as the Department of Transportation works to find the right places for them, which have to meet an extensive list of requirements. Five are currently in operation, and the department is taking location suggestions for the remaining toilets — possibly a recipe for N.I.M.B.Y. (“not in my backyard”) complaints.
San Francisco started the Pit Stop program in 2014, after hearing from children in the Tenderloin district that they were stepping around feces on their way to school, said Rachel Gordon, the director of policy and communications for San Francisco Public Works.
They started with three bathrooms, and today have 33, with hours varying by location. (The amount expanded to 60 locations when homeless shelters closed during the pandemic, Ms. Gordon said, but the temporary stalls have since been removed.) Each has running water, soap, needle disposal boxes and dog waste receptacles as well as one or two attendants working. According to a study conducted by the University of California, Berkeley, feces reports declined by 12.47 a week in the Tenderloin district during the six months after the first Pit Stops opened.
The public restrooms in Portland, Ore., are available around the clock. The Portland Loo is a gender-neutral, wheelchair-accessible, single-stall bathroom that costs $100,000 per unit.
The city created the concept in 2008 with a goal of building a simple structure that couldn’t be vandalized. Each bathroom is connected to the sewer system and has running water and electricity (provided by solar panels in some). The units are lit in blue, which makes it difficult to find veins and thus discourages drug use, said Evan Madden, the sales manager at Portland Loo.
The toilets are ventilated to control smell and overheating; the vents also provide just enough privacy for the restroom’s purpose, but not enough for sleeping or sex work. It’s “intended to be uncomfortable for the occupant,” Mr. Madden said.
In 2013, after Portland turned the sales and manufacturing operation over to Madden Fabrication, 180 units have been installed across North America.
Vancouver, Wash., installed three Portland Loos at a 7,000-acre waterfront park in 2018 — a response to typical problems: The city’s public bathrooms “have really taken a beating, and our police can’t monitor what activates are going on in them,” said Terry Snyder, the landscape architect for Vancouver’s Department of Parks, Recreation and Cultural Services.
The Portland Loos have worked well enough that Mr. Snyder said the city would be installing three more this summer at the Esther Short Park, replacing a 22-year-old brick bathroom building.
Philadelphia is also planning to install six Portland Loos in the next five years, with the first opening in Center City sometime this year.
Mr. Soifer of the American Restroom Association believes that the issue in the U.S. should be addressed on a national level rather than having a patchwork of individual solutions. His group has had multiple meetings with the U.S. Department of Health and Human Services hoping it would step in to handle public restrooms — much like the Occupational Safety and Health Administration is responsible for toilets in the workplace — but to no avail.
“Given that this really is a public health issue, someone has to take responsibility,” he said, “and no one is.”
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