In his 24 years living unhoused in Los Angeles, Robert Garcia spent most of his time worrying about three things: what he was going to eat, where he was going to sleep, and how he was going to pee.

“It’s something you’re very preoccupied with,” he told me by phone. “It’s just something you’re constantly dealing with.” The 50-block Skid Row area of Downtown LA is lined with makeshift encampments, occupied by the largest concentrated homeless population in the United States. But the 15,000 people who live there share access to only five portable toilets—which are frequently out of order, short on supplies or locked after sundown.

For residents like Garcia, these provisions are woefully inadequate. He recounted a time a few years back when he had to urinate in the middle of the night and began doing so as discreetly as possible outside his tent.

“As soon as I start…the police pull up and shine a light on me,” he recalled. “They don’t get out of the car, but they’re looking at me and shining the light and pointing it at me. They say, You know what you’re doing is illegal, right? We can arrest you and take you to jail, right? And we can have you declared a sexual offender and put you on a list.’”

Garcia’s mind raced—he’d been caught mid-act, and there was no denying what he’d been doing. “I tried to be polite and deferential as I could. They have all the power in this situation, and I have no power. I’m just going, ‘Well, sir, I’m trying to make the best of a bad situation, I’m sorry, I apologize…. I’d rather not be in this situation.’ And as all this is going on, they get another call and just turn their flashing lights on, start laughing and drive away.”

That close call, Garcia knew, could have panned out much worse: A recent survey conducted by the National Law Center on Homelessness and Poverty found that some 20 to 30 percent of homeless respondents had been cited or arrested for public urination, funneling them into a criminal-justice system that threatens to leave them even more destitute and with less access to housing and employment in the future. And because California is one of the 13 states that classify public urination as a sex offense, the registry the officer allegedly threatened Garcia with could have made his prospects of securing employment or housing even worse than they already were.

The widespread criminalization of public urination—the consequences thereof obviously hitting society’s most vulnerable people the hardest—illustrates a broader truth: Pee is a class issue. Access to adequate restrooms whenever you need them is a fundamental need that’s harder to come by the less structural power you have. If struggling to find suitable toilet facilities in public is a near-universal human experience, that challenge becomes more acute the more marginalized you are.

Restrooms outside the home have always served to reify norms of who is and isn’t welcome to occupy public life. Many early versions in places of public accommodation contained only urinals and were intended for men only; women were presumed to be confined mostly to the home and not in need of facilities suited to their needs. The rise of industry, leisure, and better sanitary practices in the late 19th to early 20th century began to change that, and ladies’ rest areas began popping up in department stores and cafes to attract business. Meanwhile, public toilet facilities in many places remained heavily segregated by race.

By the early 1970s, there were an estimated 50,000 pay toilets in America, making up a large portion of public toilet stock. It’s a quantity that seems unimaginable today to pedestrians, even if toilets at rest stops for motorists have remained commonplace. But there was a catch. On the Pennsylvania Turnpike, for example, the overwhelming majority of them were pay toilets and required a dime to open the lock.

Pay toilets became the target of protest in the late ’60s and early ’70s. After being elected in 1966, California Assembly member March Fong led a successful war on public pay toilets in her state. At the height of the second-wave feminist movement, she argued that women shouldn’t be forced to pay 10 cents to use a toilet while men had mostly free access to urinals.

In 1970, four high-school students from Dayton, Ohio, decided to fight the tyranny of needing exact change to relieve their bladders and formed a group called the Committee to End Pay Toilets in America (CEPTIA). “We feel that pay toilets are unjust infringements on our basic human rights,” they wrote in a newsletter. “Elimination is an important body function that must take place, dime or no dime.” As Aaron Gordon illustrated in a history of pay toilets in Pacific Standard, CEPTIA was surprisingly effective in helping to stamp out the $30 million annual pay-toilet industry. And while some of CEPTIA’s opponents defended the dime entry fee as necessary for maintenance and upkeep, others were forthcoming about the paid lock’s function as a class barrier: As one gas station owner allegedly put it, “If a man ain’t got a dime in his pocket, he shouldn’t be using my restrooms.”

In Gordon’s telling, by 1980, pay toilets had been virtually wiped out in the United States, banned by several state legislatures in light of CEPTIA’s campaign (even as city officials deployed fear-based arguments against them, claiming that they would become hotbeds of homosexual activity, drug use, or other criminal behavior), and made politically tainted where they remained legal. But the teenagers’ victory over commodified bathroom breaks had unintended consequences: Many cities have since refused to build public restrooms, and those that remain have fallen into disrepair. City officials cite the absence of sufficient funds for maintenance and operating costs as the culprit. In short, despite the more idealistic intentions of the movement fighting to take down paid toilets, their closure arguably made public restroom infrastructure even worse.

Just as thousands of pay toilets across the country began to shutter, other large-scale social problems were getting worse. As income inequality widened and austerity eroded public-housing and welfare programs, homelessness began to rise, fueling a crisis that persists. Thousands of people were forced to live outdoors at the very moment when restrooms were becoming less available than they’d been in decades.

Even today, it can be vexingly difficult to access toilets in public, and public libraries are some of the few places anyone is allowed to use restrooms without buying anything. Some commercial spaces allow noncustomer bathroom use on a case-by-case basis that all too often operates on race and class lines: While a rich white person may easily buy an unwanted item in exchange for a business’ bathroom key or traipse toward the restroom unnoticed by management, the situation is likely to play out differently for anyone perceived not to belong in the place. As Pete White, the executive director of Los Angeles Community Action Network (LACAN) said, “I want to be clear. There’s not a lot of public-health infrastructure anywhere. But the poorer you get, the more challenged you are in your ability to access.”

In a phone interview, White explained how grassroots organizers in Los Angeles have been fighting for better public-restroom infrastructure since the 1980s. While it is traditionally framed as a sanitation issue, which prioritizes clean streets over human needs, LACAN’s efforts emphasize toilet access as a matter of human rights and public health. According to reports the group released in 2012 and 2017, Skid Row is 382 toilets short of meeting the United Nations minimum for refugee camps. LACAN’s research also suggests that restricted toilet access could be linked to a recent outbreak of hepatitis A, as well as susceptibility to urinary-tract infections—both of which are difficult to access treatment for while poor and unhoused. When it comes to the intersection of health and toilets, LA is no outlier: Studies elsewhere have suggested that unhoused people experience health problems from holding their urine or are likely to skip doses of medication whose side effects include frequent urges to use the bathroom.

Of course, as White noted, bathrooms are a site of inequality not only for unhoused people. Low-income urban neighborhoods, like those in LA, tend to have high rates of overcrowded housing, defined by more than one resident per room, which makes toilet access a scarcer resource than it might be in homes with more bathrooms. Furthermore, given the ubiquity of slumlords who withhold necessary repairs to reduce maintenance costs or drive out unwanted tenants, functional bathrooms are less likely to be found in poor and precarious households whose occupants exercise little control over their residences.

Even for those with adequate housing, the challenge of finding suitable facilities outside the home intersects with many aspects of oppression. The group most disproportionately affected is women, who take about 50 percent longer to use the bathroom than men do, resulting in staggering queues outside gender-segregated restrooms. For many, pregnancy increases the urge to urinate. Women are more likely to menstruate, lactate, change diapers, or be accompanied by children, each of which may require unplanned trips to the bathroom. The fact that they’re forced to expend time and energy tracking down appropriate facilities is ironic, given the fact that many of the local jurisdictions that banned pay toilets in the 1970s did so on ostensibly feminist grounds: Many restrooms contained locks on stalls but not urinals, and backing the ban could be framed by progressive-minded politicos as a low-risk nod toward women’s liberation.

Betty Ellis, first US female soccer linesman, takes a break in the men’s locker room on May 11, 1981 in Santa Rosa, California. There was no lady’s toilet at the stadium. (AP Photo)

Trans women, who are nearly four times as likely as their cisgender peers to experience extreme poverty, face particular hardship using public facilities. Their mere presence in them has inflamed intense partisan debate, with multiple jurisdictions passing so-called bathroom bills that enforce restroom segregation by gender assigned at birth. Trans people are disproportionately unsafe in restrooms they can access, with one study showing 70 percent of respondents having experienced harassment or physical violence in them.

Adequate, free access to bathrooms is also a frequently cited issue in the workplace. In 2014, a Teamsters local in Chicago filed a complaint that one faucet company had unfairly penalized 19 workers for using the bathroom too much. Amazon warehouse workers have reported peeing in bottles out of fear of missing grueling productivity targets; a call center worker sued the tech giant for allegedly refusing to accommodate his medical need for frequent bathroom breaks. One survey of food-processing-plant workers in Alabama, where the overwhelming majority of workers are not unionized, found that 80 percent had bathroom breaks restricted by bosses. In short, in some labor settings, the basic need to use a toilet is regarded as a form of time theft.

Finally, ensuring free use of toilets is a critical disability-rights issue. In 2004 an Illinois teenager, Ally Bain, had a Crohn’s disease flare-up while shopping with her mother and was forced to relieve herself in the store after the manager refused to allow her to use the bathroom. Afterward, she pushed for the passage of Ally’s Law, later adopted by several states, which stipulates that businesses must provide restrooms for people with certain medical conditions. But the rule is difficult to enforce, leaving toilet access largely up to individual discretion.

It was these accessibility issues that inspired Carol McCreary to start an advocacy group, Public Hygiene Lets Us Stay Human (PHLUSH), in 2005 for accessible toilets. With parents in their 90s and a disabled husband, she recalled having to plan routes around toilet availability. The group spearheaded efforts to install public toilets around Portland, Oregon, which is now regarded as a model for other cities.

So if toilet access is so deeply enmeshed with social and economic justice, why isn’t it discussed that way? For McCreary, the answer is obvious. “At the very beginning, we were hounded by the press,” she recalled. “They thought it was hilarious…. We had every pee-pee, caca joke in a headline that they could within the first month.” Still, she said people are finally coming around to discussing policy related to bodily functions like adults. “It’s never been on anyone’s public policy table. Now it’s starting to be.”