HealthDenying access to restrooms has serious health ramifications for...

Denying access to restrooms has serious health ramifications for gender non-conforming people

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The Madras High Court recently sanctioned the creation of three gender-neutral toilets on campus, after advocate and transwoman R. Kanmani, wrote to the Chief Justice last November, pointing out the need to have gender-neutral toilets in addition to the existing ones on the court premises.

“I have been working there since April 2023, and usually avoid using the restroom as there are no gender-neutral toilets on campus,” says Kanmani, adding that it has taken a toll on her physical and mental health. “In October this year, I received a letter from the Madras HC, conveying that it had directed the construction of three such toilets on campus.”

This marks another milestone in the LGBTQIA+ fight for equal rights. Right to sanitation is recognised as a human right by the United Nations. However, according to a 2020 World Bank report, only 72% of people in India have access to sanitation. When it comes to gender non-conforming people, the situation is worse as they are denied admittance to gendered restrooms, and face violence while using these facilities.

No hard data

There are no statistics available about the number of gender non-conforming people in India. As per the 2011 census, there are 4,87,803 transgender people in the country (who identify as other than male or female) but this doesn’t include those who identify within the binary, or those staying with natal families and who may have chosen not to disclose their non-binary trans status out of fear of facing domestic violence.

Many of them are forced to “hold” their stool and urine for hours on end. So, they avoid eating or drinking when they are outside, which naturally, has an impact on their health. Gendered restrooms are also often spaces where they experience violence – verbal, physical or sexual. “A lot of gender non-conforming children have faced violence while using restrooms in schools. They are asked to remove their clothes, forced to display their genitals when they go to bathrooms that correspond to their biological gender,” says L. Ramakrishnan, vice president of the public health NGO, SAATHII, adding that such cases have been documented across India in educational institutions, workplaces, and public spaces

Kanmani was subject to a nightmarish experience, when, as a 23-year-old law student, she stepped into a women’s restroom at the Kashmere Gate metro station in Delhi, to fix her saree. “All the women inside rushed out. I was forced to go to the men’s restroom as the toilet for persons with disabilities was locked. Half the men left but the others using the urinals turned and exposed their genitals to me. I shouted, cried and tried using a stall where I could quickly drape my saree and leave, but they didn’t allow me to do so,” she says. This went on for half an hour, with people throwing slurs and cuss words at her. It lasted until one of the women sanitation workers managed to get the key for the washroom for persons with disability, and took her there. “She was the only one who was kind to me,” says Kanmani.

Fred Rogers, a man of trans experience and a trans rights activist, remembers the horrific experience he had prior to his top surgery at an airport in Goa. “As I was about to enter a women’s toilet, an old man chased me with a stick, shouting that I was about to rape a woman,” says Fred. “In school, I refrained from using gendered restrooms because I was not comfortable using the girls’ restroom and the one for boys was not safe. Gender non-conforming people are abused, stripped, and even forced to do sexual acts in restrooms. People assume that we are not equal citizens, and that attitude contributes to the violence that happens in restrooms.”

In April 2022, he filed a petition with the Madras High Court, asking for “single occupancy, gender neutral toilets/ all gender toilets in addition to the existing gendered restrooms in educational institutions, malls, bus stations, railway stations, airports and other public places in Tamil Nadu.

Violence in schools, public spaces

Even when they have parental support, gender non-conforming children face violence in schools. When Guwahati-based Indrani Chakraborty’s child came out as a trans girl when she was in class 7, Indrani visited the school and changed the gender and name of her child on the school records. “But, in school, her fellow classmates and seniors dragged her to the boys’ restroom, and removed her clothes to check her genitals. Her complaints were initially not taken seriously, but finally they provided her with a separate toilet,’ says Indrani. But, later a few students, parents and teachers ganged up against her daughter. “She was pulled up for random things and slut shamed. Finally, after class 10, we opted for open schooling under NIOS,” she further adds.

Kolkata-based clinical psychologist Aritra Chatterjee, a member of the community, says that even the way restrooms are designed pose a challenge to gender non-conforming people. “Even if a transman/ transmasculine person ‘passes’ (looks and presents like a man) and uses the men’s toilet, they are unable to use the standing stalls or urinals. Most toilets have only one or two closed stalls, which they can use and a person who regularly uses only that facility becomes earmarked, and ultimately, a target of violence,” she says.

Health impacts

Holding your urine and stool for a long time can have a serious impact on your health. “It can lead to urinary tract infections, incontinence, renal stones and constipation-related issues like anal fissures, haemorrhoids, as well as gastric issues,” says Palakkad-based transwoman Vibha Usha Radhakrishnan, a medical professional.

Community members, activists and allies have been campaigning for the establishment of single-stall, gender-neutral toilets in educational institutions, workplaces, government institutions and public spaces.

In Assam, Rituparna, founder-director of Akam Foundation, launched a campaign, #NoMoreHoldingMyPee, in June 2022. “A female-assigned, non-binary person, who considers me his mother, stopped going to college as he had to always wait for a friend to escort him to the toilet, he could not go otherwise. That moved me to take action,” says Rituparna, who highlighted the need for gender-neutral restrooms in educational institutions across Assam during the Pride Walk in October 2023.

And things are slowly changing. In 2023, the Supreme Court of India announced that nine gender-neutral bathrooms were being set up on the court premises. Institutions such as the Indian Institute of Technology (IIT) Delhi and the National Academy of Legal Studies and Research (NALSAR), Telangana, have introduced gender-neutral restrooms on their campuses. IIT Delhi established 14 gender-inclusive restrooms in the lecture hall complex in 2022 after members of Indradhanu, the LGBTQIA+ collective of IIT Delhi, met with the authorities. Some hotels, educational institutions and corporates have created similar facilities.

But the psychological damage caused by ‘holding urine’ and the violence suffered has a lasting impact, says Ms. Chatterjee, who counsels members of the community. “There is a tremendous sense of alienation and social isolation over an act so mundane as urinating. It affects the person’s quality of life. There is anticipated stigma and discrimination along with trauma (if you have experienced violence), and constant fear leads to complex psychological issues that people have to battle all their lives,” she says.

(Priya M. Menon is a Laadli Media Fellow. The opinions and views expressed are those of the author. Laadli and UNFPA do not necessarily endorse the views. menonpriya2704@gmail.com)



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