If there is a key statistic in Lezlie Lowe’s deeply reported and engagingly anecdotal book about Canada’s public-access washroom situation, it is ensconced deep inside, when Steven Soifer gets lost in some surprisingly appalling arithmetic. Soifer, CEO of the International Paruresis Association, is one of the few activists willing to talk openly about his condition, better known as shy bladder syndrome. Classified as a social anxiety disorder in the American Psychiatric Association’s bible, Diagnostic and Statistical Manual of Mental Disorders, paruresis renders urination nearly impossible when others engaged in the same task can be seen or heard. The condition has been mined for its comedic possibilities by more than one television writer, but it poses a special need in the real world for those who suffer from it. Trying to count off the proportion of the general population who, at least at times, are underserviced or unserviced bathroom users, Soifer starts with those who have paruresis: about seven per cent. Add the incontinent, another seven per cent, then “throw in menstruating women, parents with kids, people with ostomies.” He stopped there, Lowe records, and trailed off. He didn’t even get to the elderly.
No Place To Go: How Public Toilets Fail our Private Needs may be far more descriptive than prescriptive, but it does a superb job of summing up the Canadian public toilet situation—which is, in a word, crappy. And in making it very clear that while everyone in this clenched-bladder Presbyterian nation has an access problem—we don’t even like to think about public loos, let alone build them—Lowe underscores the reality that millions of Canadians have particularly acute issues. The plain fact is that there are not enough of them, glaringly so in cities where urban planners dream of walkable communities. Lowe also moves through details that matter to particular groups—people who need to change colostomy bags need shelving, while local authorities, who believe all “extraneous” details are simply magnets for vandals and drug users, disagree—and into competing desires. Gender-blind bathrooms would be very helpful for non-binary people, who can face hostile scrutiny, and sometimes worse, in a sexually segregated system; safe-space-for-women-only advocates—who acknowledge this reality—push back against that particular solution.
And, yes, this is a first-world problem, quite possibly the very epitome of that concept. The developed world has perfected the art of whisking its waste out of sight (and smell). While Westerners are engaged in a desultory debate over who gets to deposit her minute contribution where, almost 900 million people elsewhere in the world practice open defecation—which is exactly what it sounds like. Water-borne fecal diseases kill one child every fifteen seconds. Human waste, as noted in Rose George’s seminal 2008 book, The Big Necessity, is human health’s single greatest hazard. Even so, not all those 900 million live far away. Open defecation goes on in every Canadian city, and there are powerful barriers between the homeless and toilet access—try googling, Lowe suggests, “Tim Hortons” and “angry pooper.”
Still, the problems here are real enough, even if most Canadians, and Westerners in general, are happy to dwell in a flush-and-forget idyll. The century-old infrastructure underpinning our waste removal system is under assault from its own antiquity and from burgeoning urban populations. Far more people means far more excrement, metaphorical and real, than municipal disposal systems were designed for. Much of it goes down the toilet, and sometimes it clumps together in what the British call fatbergs, quintessentially contemporary amalgams of tampons, condoms, cooking oil, wet wipes and human waste. In 2017, the largest fatberg yet encountered, the size of eleven double-decker buses, was discovered, fittingly enough, under Jack the Ripper’s old stomping grounds in London’s Whitechapel. An eight-man crew laboured some ten weeks to remove it.
But the big existential questions about human sewage and human destiny are not the primary interest of the toilet activists—whose numbers include Lowe herself—of No Place To Go. They are focused on the small existential questions, like equality, dignity, and having the freedom to move about their communities. The activists, as is only to be expected, are primarily women. The public washroom “system,” such as it is, skews heavily male. According to the rule of thumb cited by Lowe, seven of the eight daily washroom visits by healthy, able-bodied, middle-aged sorts are liquid in nature. Men generally have minimal trouble finding an open urinal; failing that, trees, bushes, and grotty alleyways still abound.
Women not only need actual toilets, they need them more often and for longer visits: studies show that women take up to fifty per cent longer to empty their bladders. They need more user end points than men, and have fewer. Side-by-side male and female washrooms with equal floor space mean that the men’s room, through a combination of three or four urinals plus one or two stalls, will accommodate more visitors at a time than a four-stall women’s. And that is just the physical situation, before the social norms are added in.
Women are much more likely to be accompanied by members of the special-needs cohort, namely small children or adults for whom they are providing care. Like a traffic jam that grows rapidly from a simple choke point, women’s lineups arrive and expand almost spontaneously, and localized emergencies are as common as biological urges. (Full disclosure: Once, while coping with my elderly mother’s sudden, urgent need while waiting for a medical appointment, I took her to the small women’s washroom that serviced several doctors’ offices. The entire two-stall space was fully occupied by one woman and five preschoolers, two on the toilets and three holding their crotches while hopping up and down. I wheeled out, parked my mother in the hall, went into the men’s—three urinals, one stall—threw out the teenaged boy combing his hair, brought my mother inside, and stood at the door, twice turning away very surprised men who tried to enter.)
You too, dear reader, have a toilet story to tell, although you may prefer to suppress it. Everybody has one, Lowe writes. She shares her own—an undignified girlhood accident while stuck in line at the women’s room and staring at the empty men’s—as well as the tale of the nanny who trained her three-year-old charge to pee on the back of an electrical box in an Ottawa park, one of public Canada’s ubiquitous restroom deserts. (“I wasn’t sure,” commented the nanny’s employer, “if that was an attempt at privacy or a passive ‘Fuck you’ to Parks and Rec.”)
Yet how easily we let those moments slide out of our consciousness. Most people can count on their home bathrooms, on workplace or school access and, unconsciously, the benefit of the “pee tax”: buy a movie ticket or restaurant meal, and access to washrooms is automatically included. Sometimes, as in a not insignificant number of purchases in cafés, what we really want is the toilet: the coffee, which will only force many drinkers to repeat the cycle, is an indifferently welcomed add-on. But not everyone toils in an office. One of Lowe’s expert “toilet ladies,” a sociologist studying the working experience of New York cabbies, found her research interests veering in a new direction after she approached one taxi, only to find the driver busy filling a coffee cup with urine. Truck drivers, who have nowhere to park their rigs once they leave the highway, are notorious for the “trucker bombs” that line the North American road network—plastic containers filled by driving-while-peeing truckers and tossed out the window.
The constituency most emblematic of our studied avoidance of the toilet topic is the elderly. Not because their needs are more worthy than others, but because literally everyone, from gerontologists concerned with their health to governments worried about their health-care costs, wants them to get out there and walk. Yet entire strategic plans—Ontario’s Action Plan for Seniors, New Westminster’s Livable City Strategy, Toronto’s plan for breaking down the barriers that keep seniors housebound—don’t even mention toilet access. They are all about green spaces, benches, traffic-calming measures, and accessible buses, even though, in terms of personal dignity, weak bladders are a much bigger factor than arthritic knees.
But if anyone’s needs finally cause a thousand loos to bloom in our toilet desert, it will be those of the elderly, with their exploding numbers and high voting rate. Perhaps not this generation, too reticent to discuss the sort of personal details that might enlighten urban planners, but their successors—baby boomers, who are about as stoical, generationally speaking, as thwarted toddlers—won’t have that problem. Soon enough, someone is going to raise enough of a stink to make a difference.
Brian Bethune is a writer and book critic in Toronto.