![\"A](\"https:\/\/i0.wp.com\/timesofsandiego.com\/wp-content\/uploads\/2026\/03\/Thomas-Murphy-Bathroom-Access-2.jpg?ssl=1\")
<\/a>Franky Arambula along his old delivery route in San Carlos. He transitioned while assigned to the suburban neighborhood. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\nDuring the busy Christmas season in 2022, he tried the bathroom door to find it locked. Confused, he went to the apartment\u2019s office. Arambula assumed maintenance had accidentally locked it. A receptionist told him it was now for residents only.\u00a0<\/p>\n
\u201cShe tells me, \u2018I\u2019ll go ahead and open it this once, but a property manager doesn\u2019t want you using the restroom anymore,\u2019\u201d Arambula, 37, recalled.\u00a0<\/p>\n
Arambula, a trans man, will always wonder if his transition prompted the locked bathroom doors. It occurred in a complex where he knew everyone\u2019s names and had delivered mail to them for years.\u00a0<\/p>\n
\u201cI\u2019m being turned away and I\u2019m supposed to be an essential worker,\u201d Arambula said. \u201cThey\u2019re not going to tell you it\u2019s because you\u2019re trans, but, in the back of my mind, it\u2019s going to be like, \u2018but what if?\u2019\u201d\u00a0<\/p>\n
What is not in question is the dire health consequences the closure caused. His irritable bowel syndrome worsened, leading to prolonged absences from work.\u00a0 <\/p>\n The public bathroom is an amenity that dictates who can and cannot be part of public life. A healthy adult may be able to \u201chold it\u201d if no bathroom is available, but it can exacerbate the marginalization of people with disabilities, gender non-conforming people and other groups who stay home, and out of public view, if no safe bathroom option exists.\u00a0<\/p>\n Arambula\u2019s doctor later diagnosed him with pelvic floor dysfunction, a condition found in some truck and delivery drivers. The doctor directly blamed holding it in for prolonged periods as the cause of the dysfunction, which could result in a lifetime of diaper use.\u00a0<\/p>\n Arambula has grown more convinced of what happened. Yes, it was transphobic, he increasingly thinks. His physical appearance had begun to change just as the incident occurred. It was no longer just him announcing that he wanted to be addressed in a certain way. Now, his transition was physically manifesting through hormone replacement therapy.<\/p>\n \u201cI stood out a lot,\u201d Arambula said.\u00a0<\/p>\n Arambula is not alone in experiencing life-altering health consequences from lack of bathroom access, nor is he the only gender-diverse San Diegan in the situation.\u00a0<\/p>\n Cecile Ferrando, a urogynecologist at UCSD Health, has treated gender-diverse patients with kidney, bladder and pelvic floor issues attributed to not using the bathroom enough.\u00a0<\/p>\n \u201cThere\u2019s a lot of downstream consequences of not being able to access the bathroom throughout the day,\u201d Ferrando said.<\/p>\n Surveys of transgender people have found<\/a> bathroom avoidance in portions of the population<\/a>, either from fear, anticipation of discrimination or trauma from past experiences. That has public health consequences.\u00a0<\/p>\n \u201cWhen patients either can\u2019t access a bathroom or don\u2019t feel safe accessing a bathroom, they\u2019re much less likely to hydrate properly,\u201d Ferrando said. \u201cSo fluid restriction is a real thing which can affect bladder and overall health. Access to a restroom is not just a convenience, it\u2019s a basic health need.\u201d\u00a0<\/p>\n Mason Dunn, a contractor at the Naval base in Coronado, described rationing water even in the summer to avoid using the bathroom. His workplace, because it is on federal property<\/a>, has legally obligated him since 2025 to use the bathroom of his sex assigned at birth, not his gender.\u00a0<\/p>\n \u201cI have to use the women\u2019s restroom still, but because of how I look, I\u2019m very cautious about going to the bathroom,\u201d Dunn said. \u201cSo I try to go only once a day while I\u2019m at work, if I can help it.\u201d\u00a0<\/p>\n He has yet to experience any health concerns related to this, but others have.\u00a0<\/p>\n These health complications, either caused by or worsened by a lack of public bathrooms, make the challenges of being gender diverse in a world with mostly gendered bathrooms more difficult.\u00a0<\/p>\n \u201cIt\u2019s something that I wish I didn\u2019t have to think about.\u201d\u00a0<\/p>\n Kuzon Itahana<\/p><\/blockquote>\n \u201cOn the rare occasion I find a specifically marked gender neutral bathroom, it makes me realize how much stress I feel having to deal with gendered bathrooms,\u201d said Kuzon Itahana, a nonbinary 28-year-old.<\/p>\n Another local disabled transgender person, Jerry McCracken, limits travel to a 30-minute radius from his home in Chula Vista where he knows the locations of wheelchair accessible bathrooms in local businesses.\u00a0<\/p>\n McCracken transitioned in the \u201890s, before California law permitted people to use the bathroom that aligned with their gender identity<\/a>. Instead, transgender people waited until they could blend in to use gendered restrooms.\u00a0<\/p>\n \u201cIt was like \u2018you\u2019re not going into any public restroom. Period. End of statement. No. Either go at home or you hold it,\u2019\u201d McCracken said. \u201cSo there are members of the community who end up with UTIs.\u201d\u00a0<\/p>\n While laws have changed<\/a>, legal rights and realities on the ground are not always aligned.\u00a0<\/p>\n \u201cYou certainly can\u2019t legislate against people expressing their fears in a way that\u2019s discriminatory,\u201d Ferrando, the urogynecologist, said.\u00a0<\/p>\n At this point for the bushy-bearded and balding man, McCracken\u2019s gender does not affect his bathroom use, but his disabilities, including Crohn\u2019s Disease, diabetes and mobility issues, do.\u00a0<\/p>\n For now, Itahana uses the women\u2019s bathroom, but hormone replacement therapy could make that more difficult.<\/p>\n \u201cI find myself starting to worry about eventually looking not-female enough for the women\u2019s restroom, but\u2026 I also worry about getting called out in men\u2019s restrooms,\u201d Itahana said. \u201cBeing nonbinary definitely complicates public bathroom experiences.\u201d\u00a0<\/p>\n \u201cBeing nonbinary definitely complicates public bathroom experiences.\u201d\u00a0<\/p>\n Kuzon Itahana<\/p><\/blockquote>\n Sam Cay, who is also nonbinary, wishes there were more gender neutral public bathrooms available, ones that didn\u2019t make them have to pick a gender they are not.\u00a0<\/p>\n \u201cI have to accept being misgendered in those bathrooms so that my basic need can be met,\u201d Cay said. \u201cWhy does it have to be a compromise? Why can\u2019t it just be a right?\u201d<\/p>\n Gender diverse people describe elaborate rituals to feel safe in the women\u2019s restroom: Listening at the door to make sure it\u2019s empty, puffing out their chest so women feel safe, having a female coworker sweep the bathroom to ensure it\u2019s not being used, throwing on a large hoodie to disguise their appearance, not leaving the stall unless the bathroom is empty, carrying hand sanitizer to avoid using highly-visible sinks.\u00a0<\/p>\n The men\u2019s restroom has its own issues: Lack of stalls, lack of privacy, general dirtiness and safety concerns.\u00a0<\/p>\n On New Year\u2019s Eve on a visit home to Missouri, San Diego State University student Zachary Willmore was accosted for being \u201cdressed like a girl\u201d<\/a> in the men\u2019s bathroom in a viral video that shocked viewers, while Willmore maintained the confrontation was far from an outlier.\u00a0<\/p>\n \u201cThey don\u2019t want transgender women to use the women\u2019s bathroom,\u201d Willmore said on his viral video. \u201cThey don\u2019t want gay men to use the men\u2019s bathroom. I guess I\u2019ll just piss on the floor.\u201d<\/p>\n Dealing with stares, comments, fear and discomfort from others can happen in any multi-stall bathroom, leaving gender non-conforming people with difficult choices.\u00a0<\/p>\n \u201cDo I bite the bullet and go to the bathroom nearby, in the women\u2019s bathroom, or do I stick to my guns and go to a whole other building for a gender-inclusive bathroom?\u201d Cay said.\u00a0<\/p>\n For Cay, developing disabilities, including incontinence, took that choice from them.\u00a0<\/p>\n \u201cThe stress has been so intense that I will take whatever bathroom at this point,\u201d Cay said.\u00a0<\/p>\n Cay\u2019s incontinence has worsened since becoming unhoused, partially due to infrequent bathroom access. Cay may need to permanently use a catheter, which carries risks like infections and sepsis, particularly in their unsanitary living conditions.\u00a0<\/p>\n Itahana now stays home due to lack of bathroom access like Cay once did. When forced to go out \u2013 either for work, necessary errands or from becoming unhoused \u2013 it led to worsening health.\u00a0<\/p>\n Itahana did not develop bladder dysfunction until becoming unhoused.\n<\/p>\n Many of the health concerns around lack of bathroom access exist for unsheltered people too, not just workers in fields like delivery driving. And becoming unhoused is not an outsized concern for gender diverse communities. In the most-comprehensive study of transgender people in the U.S., first published in 2015, 30% of respondents had been homeless in their lifetimes.\u00a0<\/p>\n \u201cI have bladder problems to this day because I would often have to wait long periods of time before I\u2019d be able to get to a bathroom,\u201d Itahana said.\u00a0<\/p>\n Without a car, Itahana depends on a transit system with few bathrooms and long wait times between, which makes it difficult to plan a trip with bathroom access. Due to the frequency of their bathroom use, they often stay home.<\/p>\n<\/a>Franky Arambula photographed along his old delivery route in San Carlos, which mostly consisted of single-family homes. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\n<\/a>Franky Arambula photographed along his old delivery route in San Carlos. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\n<\/a>Franky Arambula attempts to open a locked all-gender bathroom at a Jack in the Box on Mission Gorge Road, a couple miles outside his old route. He said the Jack in the Box was a frequent stop for construction workers, landscapers, delivery drivers and other professionals who needed access to a bathroom. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\n\n
<\/a>Jerry McCracken, right, photographed with Eddie Caballero, the owner of the Antique Row Cafe in University Heights. McCracken befriends business owners like Caballero to ensure he can find a bathroom when he needs one. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\n<\/a>Jerry McCracken in front of the all-gender bathrooms in the Antique Row Cafe in University Heights. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\n\n
<\/a>Sam Cay outside the Spanish Landing Park bathroom. As a safety measure, they puff out their chest while using the women\u2019s bathroom, despite this causing dysphoria. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\n<\/a>Kuzon Itahana at the Old Town Transit Center on March 28, 2026. Despite being one of San Diego\u2019s biggest transit centers, it does not have a public bathroom. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\n<\/a>Sam Cay outside the Spanish Landing Park bathroom. When Cay learned they would be living out of their car, the first thing they did was try to find bathrooms open to unhoused people. (Photo by Thomas Murphy\/Times of San Diego)<\/p>\n