Why are public toilets still so rare?

When a visiting friend asked me to run in Philadelphia, I had a lot planned. Not only our route, but also where we go to the toilet. It didn’t go well.

I took the PATCO Speedline, which doesn’t have toilets on trains. The station I left from in southern New Jersey didn’t have one either, nor did the one I arrived at in Philadelphia. When I got to my friend’s hotel, the lobby bathrooms were locked.

Luckily, I was able to follow a woman into the bathroom with a passcode. But that was luck. Relying on the whims of fate was my only option because the United States – and much of the world – has a problem with public toilets.

According to the Public Toilet Index, a 2021 report by British company QS Bathrooms Supplies, there are on average just eight public toilets for every 100,000 people in the United States. That’s way behind Iceland, the country with the highest density of public toilets: 56 per 100,000 people. In New York City, that number drops to four per 100,000. Madison, Wisconsin was the leading US city with a population of 35 per 100,000.

That was not always so. In the 18th century, before indoor plumbing, bathrooms were common and generally communal, said Debbie Miller, museum curator at Independence National Historical Park. In Philadelphia, one such octagonal outdoor toilet was located in a public garden behind what is now Independence Hall. “You could have shared the toilet with George Washington,” she said.

Acceptance of public and shared bathrooms changed during the Victorian era, Ms Miller said, as bodily functions became more taboo. The temperance movement to limit alcohol consumption prompted cities to build public toilets in the late 18th and early 20th centuries: it was thought that men did not need to enter a bar to use the toilet. During the 1930s, investment by the Works Progress Administration and the 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 Central Park.

But as city budgets dried up in the 1970s, so did resources for maintenance. Movements emerged to end the practice of paid toilets, which was seen as both sexist (urinals were often free to use but cubicles were not) and classist. Cities responded by removing public toilets altogether.

Bathrooms are “challenging spaces because they’re often the places where people meet needs they can’t meet anywhere else,” like sex work, drug use, or sleeping, said Lezlie Lowe, author of No Place to Go: Like Public Toilets miss our private needs.” “All of these are social concerns that have nothing to do with bathrooms, but because of the nature of these spaces, bathrooms are ultimately used to meet their needs, be it addiction or desperation.”

As public toilets have been closed, establishments such as cafes, museums, libraries and department stores – which are generally only open at certain times – have had to become gatekeepers of toilet access.

“We face a problem where demand for public restrooms far outstrips supply,” said Steven Soifer, president of the American Restroom Association, a group campaigning for better public restrooms. “That comes into play, who is responsible for providing public toilets?”

There are different approaches to answering this question. Some European cities have tried public-private partnerships, said Katherine Webber, an Australian social planning researcher who traveled the world to study toilets in 2018 on a Churchill Fellowship grant. She said the strongest programs have included local governments playing a role in determining the best toilet locations. “A city or place will do better if it takes into account the different needs of residents and tourists.”

In 2022, Berlin completed a public toilet expansion, increasing the number of public toilets from 256 to 418. The city looked at its existing toilets and identified where the gaps were — and then partnered with Wall GmbH, a street furniture company that also builds structures like bus stops and kiosks.

That same year, London introduced the Community Toilet Scheme, which allowed shops and restaurants to list their toilets as publicly accessible on the City of London’s website for a small fee. Business owners believed that window signs advertising restrooms would attract customers.

However, each of these approaches has disadvantages: Berlin toilets cost 50 cents per use, and the London Community Toilet Scheme only makes sense during the opening hours of the participating companies.

Some cities have adopted French ‘urinals’ – essentially fully or semi-private public urinals that have been around since the early 19th century. In 2011, Victoria, BC installed urinals that served as street art, called Kros urinals, which have four posts per unit and can also be taken to special events or bars.

But like the classic urinal, they are usually only usable for people without disabilities and those who can easily go to the toilet while standing. “They solve a tiny problem for people who already have pretty good access,” said Ms. Lowe.

Asian countries have taken a different approach, partly due to different cultural norms. While Americans approach public restrooms with trepidation because of past experiences with dirty or broken fixtures, in China, Japan and Singapore they expect their bathrooms to be clean, said Jack Sim, founder of the World Toilet Organization. Between 2015 and 2017, more than 68,000 toilets were built in China in the so-called “toilet revolution,” with a government mandate to keep toilets clean.

Tokyo turned its toilet program into public art. The Nippon Foundation sponsored the redesign of 17 toilets at Shibuya Station with eye-catching designs including a white hemisphere and glass walls that turn from transparent to opaque when the bathroom door is closed. They are cleaned and maintained through partnerships with the Nippon Foundation, the Shibuya City Government and the Shibuya City Tourism Association. (One emerging question is whether it can be scaled up to cover the large sprawling city.)

American governments have tried a patchwork of solutions. Some cities have had more success than others, although no one has tackled the problem. In 2008, New York City bought 20 self-cleaning toilets that cost 25 cents per use. But installation has stalled as the Department of Transportation works to find the right spots for them, which must meet an extensive list of requirements. Five are currently operational, and the department is taking location suggestions for the remaining toilets – potentially a recipe for NIMBY (“not in my backyard”) complaints.

San Francisco launched the Pit Stop program in 2014 after children in the Tenderloin District were heard walking on feces on their way to school, said Rachel Gordon, director of policy and communications at San Francisco Public Works.

They started with three bathrooms and now have 33, with hours of operation varying by location. (The number expanded to 60 locations when homeless shelters closed during the pandemic, Ms Gordon said, but the makeshift stalls have since been removed.) Each has running water, soap, needle disposal boxes and dog waste bins, and an attendant or two to work. According to a study conducted by the University of California, Berkeley, fecal reports in the Tenderloin County decreased by 12.47 per week in the six months after the first pit stops opened.

Portland, Oregon public restrooms are available 24 hours a day. The Portland Loo is a single-cubicle, gender-neutral, wheelchair-accessible bathroom that costs $100,000 per unit.

The city created the concept in 2008 with the goal of building a simple structure that could not be destroyed. Each bathroom is connected to the sewage system and has running water and electricity (partly by solar panels). The units are illuminated in blue, making veins harder to find and thus discouraging drug use, said Evan Madden, sales director at Portland Loo.

The toilets are ventilated to control odor and overheating; The vents also provide just enough privacy for the toilet’s purpose, but not enough for sleeping or sex work. It’s said to be “uncomfortable for the occupant,” said Mr. Madden.

In 2013, after Portland turned sales and manufacturing over to Madden Fabrication, 180 units were installed across North America.

Vancouver, Washington installed three Portland Loos in a 7,000-acre waterfront park in 2018 in response to typical problems: The city’s public restrooms “have really taken a beating, and our police can’t monitor what’s going on in them,” said Terry Snyder, landscape architect for the Vancouver Department of Parks, Recreation and Culture.

The Portland Loos have worked so well that Mr. Snyder said the city would install three more in Esther Short Park this summer, replacing a 22-year-old brick bathroom building.

Philadelphia also plans to install six Portland Loos over the next five years, with the first opening in Center City sometime this year.

Mr. Soifer of the American Restroom Association believes the problem should be addressed nationally in the US rather than having a patchwork of individual solutions. His group had several meetings with the US Department of Health and Human Services hoping it would step in to regulate public toilets – similar to how the Occupational Safety and Health Administration regulates workplace toilets – but to no avail.

“Given that this is really a public health issue, someone has to take responsibility,” he said, “and nobody is.”