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Reason 3: All-Inclusive bathrooms can be expensive.

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Reason 3: All-Inclusive bathrooms can be expensive.

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It can be expensive to have inclusive bathrooms. This may because they have more stalls than a normal bathroom. They can have more expensive equipment, such as universal changing tables. Although, the cost on these bathrooms change depending on the variables. The accessible piece of these bathrooms can be the most expensive. Overall, the costs puts many businesses, governments, etc. off.

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A. Numbers of Facilities

The following table shows the data collected on the numbers of facilities in each facility group. Generally, this data is collected from the 2007 U.S. Economic Census for private facilities and the Census of Employment and Wages for public facilities. Some facilities, such as stadiums and convention centers, have other sources as noted in the table below. Data for all facilities were adjusted to estimates for 2010 using growth rates from the February 2010 McGraw-Hill Dodge Construction Potentials Bulletin.

B. Annual Growth Rates and Alteration Rates of Facilities
3B1: Annual Growth Rates
The following table lists the rates of new construction for each facility group. These are determined from the February 2010 Dodge Construction Potentials Bulletin, which counts the number of new construction and major alteration projects for certain facility types. These projects are compared to the data on existing numbers of buildings to determine a growth rate per facility type. If no data is collected on the new construction data, a 1% growth rate is assumed. Facilities which posted growth rates greater than 1.2% were assumed not to be able to sustain such high rates of growth for 15 consecutive years and growth was capped at 1.2%. It is assumed that public facilities have the same growth rate as their counterparts in the private sector.

Facility Group

Average growth rates for new construction

3B2: Facility Alteration Rates
The following tables show the alterations rates used for the alterations schedule of the facility types included in the Final RIA. The first table below shows the alterations rates calculated from historical data on when buildings were constructed for specified building types in the EIA's 2003 Commercial Buildings Energy Consumption Survey and given the alterations schedule shown on the second row (e.g. 15 years for lodging facilities). The second table shows how the assumptions made for each of these building types applied to each of the facility types.

C. Assumptions With Respect to Estimated Typical Facility Size

This table includes with the Department's architects' assumptions on the typical facility size of each facility grouping in order to determine the estimated number of elements per facility. These assumptions were reviewed by the Cost RAP panelists. The estimated typical facility size was then used to infer the number of elements now subject to new or revised requirements (number of bathrooms, handrails, etc). The publicly owned counterparts of the facilities listed below are assumed to be the same facility size.

D. Description of Element

This table describes the elements that are subject to a requirement in terms of a unit, in order to determine the unit cost for each requirement. The unit is defined by the Department's architects. For those elements marked "N/Q", it is assumed they are not quantifiable.

E. Number of Elements Per Typical Facility

This table shows the most likely values of the estimated number of elements in a typical facility that are likely to be impacted by the requirement. The high and the low values are assumed to be plus and minus 20 percent of the most likely value.

F. Likelihood of Element in a Typical Facility

This table represents the Cost RAP panelists' assumptions and HDR's assumptions regarding the likelihood that a typical individual facility will have each element and will be affected by the incremental change to the requirement. For example, it is assumed that large facilities such as stadiums will be affected by the requirement for public entrances and that 25% of all stadiums are large enough to have the number of public entrance doors that will be affected by the change.

The high and low values that create the range of the likelihood are plus and minus 10 percentage points of the most likely values if the most likely value is less than 50% or plus and minus 20 percentage points of the most likely values if the most likely value is greater than or equal to 50%.

G. Likelihood of Element in a Typical Facility (Varying by Facility)

For some requirements, the likelihood of an element at a facility and subject to change in order to become compliant under the Rule is assumed to vary by the type of facility (hotel versus store, etc.) These likelihoods also have a "most likely" value, as well as high and low values which are equal to plus and minus 5% of the most likely likelihood value.

The most likely value is presented in the table below; conditions for the likelihood are shown separately at the end of this table. The facility-requirement matches labeled as N/A represent that the requirement is not typically present in the facility, so the likelihood that a facility would have the element to comply does not apply.

The publicly owned counterparts of the facilities below generally are assumed to have an equal likelihood of an element both existing and requiring change to bring it into compliance with 2004 ADAAG (or other alternate baseline). However, the likelihood of change for the requirements for accessible means of entry to swimming pools (Req. ## 79 & 112), accessible saunas and steam rooms (Req. ## 72 & 111), and play areas (Req. ## 99-104) at public (Title II) facilities in this Appendix take into account estimates of pre-existing compliance (or, in the case of new construction or alterations, projected compliance) with 2004 ADAAG due to overlapping program access requirements. See Section 2.4.1. First, for public Aquatic Centers / Swimming Pools, the likelihood that an accessible means of entry would need to be added (via lift or sloped entry) in order to comply with 2004 ADAAG was reduced by 70% based on sources cited in the Access Board's regulatory assessment for recreational facilities that about 70% of existing pools already provide one or more accessible means of pool entry. Id. Second, for saunas and steam rooms, this same percentage (70%) was used to scale back the likelihood for change both because saunas and steams rooms are frequently co-located with swimming pools at recreational facilities (and thus are assumed to share common accessibility levels and features) and because no public survey data exists for saunas. Third, a series of recently published surveys of play areas at large urban parks and school districts nationwide showed that the vast majority of existing play areas at these facilities, as well as play areas expected to be constructed or renovated over a five-tear planning horizon through 2011, already use (or plan to use) accessible surface materials that are compliant with 2004 ADAAG. See "Playgrounds in the Nation's Largest Urban Park Districts," Henderson Consulting Services, Inc. (March 2006); "Playgrounds in the Nation's Largest School Districts," Henderson Consulting Services, Inc. (March 2006) (both surveys available at http://www.fibar.com/Playgrounds/news.htm). Based on this survey data, the likelihoods for change for public play areas was scaled back by 50% for play areas built since 1992 (when the current ADA Standards for new construction took effect), and 25% for play areas built prior to 1992.
Conditions for change for the above requirements:
Requirement Number:

70. Accessible Route to Exercise Machines and Equipment: Facility provides accessible exercise machines but they are not on an accessible route. At hotels and motels, these likelihoods are an average of estimates by DOJ architects concerning the likelihood that transient lodging facilities would have exercise facilities that would need a change to become compliant and the survey data submitted by commenters on lodging facilities that have exercise facilities (irrespective of whether they are likely already accessible or not).

71. Accessible Exercise Machines and Equipment: Facility provides exercise machines but they lack adequate clear floor space. Again, at hotels and motels, these likelihoods are an average of the estimated likelihood value by DOJ architects used in the Initial RIA and survey data submitted by commenters on lodging facilities that have exercise facilities (irrespective of whether they are likely already accessible or not).

72. Accessible Saunas and Steam Rooms (NC): Facility provides a sauna or steam room.

73. Accessible Lockers: Facility provides lockers. Alternate conditions: Facility provides more than 20 of each type of locker (per cluster or facility).

74. Accessible Dressing Rooms, Fitting Rooms, or Locker Rooms: Facility provides dressing rooms, fitting rooms or locker rooms. In existing facilities, the change will apply to dressing and fitting rooms that provide a curtain instead of a door (if they have a door, they would already meet floor space requirements). Alternate conditions: Facility provides more than 20 dressing rooms, fitting rooms or locker rooms (per cluster or facility).

75. Wheelchair Spaces in Team or Player Seating Areas: Facility provides team or player seating area.

76. Accessible Route in Court Sport Facilities: Facility has court with no accessible route connecting both sides of the court.

77. Accessible Route to Bowling Lanes conditions: Facility has more than 20 of each type of bowling lane.

78. Shooting Facilities with Firing Positions conditions: Facility has more than 20 of each type of firing position.

79. Primary Accessible Means of Entry to Pools (NC/ALT): Facility has or would have installed a pool with only inaccessible steps or ladders. Will apply to hotels and schools only with respect to the proportion that have pools.

80. Accessible Means of Entry to Wading Pools: Facility has or would have installed a wading pool with only steps.

81. Accessible Means of Entry to Spas: Newly constructed facility would have installed spa or hot tub with only steps or seating areas. Existing facility has such a spa (most common in hotel hot tubs).Will only apply to facilities that have spas or hot tubs.

82. Accessible Route to Boating Facilities: Facility has or would have been built with no accessible route.

87. Accessible Route to Fishing Piers: Facility has or would have been built with no accessible route.

88. Accessible Fishing Piers and Platforms: Facility has fishing piers or platforms with railings, guards or handrails.

89. Accessible Route to Golf Courses: Facility has or would have been built with no accessible route.

90. Accessible Teeing Grounds, Putting Greens, and Weather Stations (Alt/BR): Existing facility has a putting green, weather shelter, and/or teeing ground. For low end of range: Terrain is such that it is infeasible to make forward teeing ground accessible.

91. Accessible Teeing Grounds, Putting Greens, and Weather Stations (NC):Newly constructed facility will install a putting green, weather shelter, and/or teeing ground.

92. Accessible Practice Putting Greens, Practice Teeing Grounds, and Teeing Stations at Driving Ranges: Facility has or will construct a practice putting green, practice teeing ground, and/or teeing stations at driving range.

99. Accessible Route to Play Components (BR): Will only apply to facilities with "medium" or "large" existing play areas that are assumed to exceed 1,000 square feet. ("Small" play areas are assumed to be 1,000 square feet or less in size and, therefore, are exempt from regulatory barrier removal requirements.)

100. Accessible Play Components (BR): Will only apply to facilities with "medium" or "large" existing play areas that are assumed to exceed 1,000 square feet. ("Small" play areas are assumed to occupy 1,000 square feet or less and, therefore, are exempt from regulatory barrier removal requirements.)

101. Accessible Route to Play Components (ALT): Applies to facilities with "small," "medium," or "large" existing play areas undergoing alterations.

102. Accessible Play Components (ALT): Applies to facilities with "small," "medium," or "large" existing play areas undergoing alterations.

103. Accessible Route to Play Components (NC): Applies to facilities with "small," "medium," or "large" newly constructed play areas.

104. Accessible Play Components (NC): Applies to facilities with "small," "medium," or "large" newly constructed play areas.

106. Post Secondary Multi-Story Dorm Facility

109. Social Service Establishments - Elevator Access (NC)

110. Social Service Establishments - Clear Floor Space around Beds

111. Accessible Saunas and Steam Rooms (ALT/BR): Will only apply to facilities that have existing saunas or steam rooms seating more than two persons.

112. Primary Accessible Means of Entry to Pools (BR): Will only apply to existing swimming pools at public (Title II) facilities and to existing private (Title III-covered) swimming pools with more than 300 linear feet of pool wall.

H. Unit Costs

Unit costs were developed per requirement to represent the high, median and low costs of compliance for an average facility based on the minimum additional cost required to bring a facility into compliance with 2004 ADAAG from the previous 1991 Standards. If current fire and safety standards exceed the 1991 Standards, then fire and safety are used as the baseline to calculate incremental costs. Not all costs will apply to all facilities. Less stringent requirements would not generate cost savings for existing facilities.

Two notes with respect to unit costs for barrier removal listed in this table bear notation. First, since existing Title-II covered facilities/requirements must comply with program access requirements only, "barrier removal" costs with respect to such facilities or requirements is technically a misnomer. However, for ease of reference, unit costs for modifications to existing such facilities/requirements - irrespective of whether covered by Title II or III - are simply herein referred to as "Barrier Removal Costs." Second, when a requirement is less stringent in 2004 ADAAG (as compared to the 1991 Standards), it is listed in this table as having zero costs for BR on the common sense assumption that facilities would not undertake to remove an element that was only no longer necessary.

[1] As applied to public or private facilities that comply with ADAAG's transient lodging provisions, which are more stringent than the new (less stringent) requirements for dwelling units.

[2] As applied to public dwelling units that comply with UFAS, which is less stringent than the new (more stringent) requirements for dwelling units.

Source: The Austin Company in consultation with the Department and HDR.
Notes on Unit Descriptions for Play Areas: Accessible play components: Small playground: Under New Construction:
· Low cost -- no cost

· Medium cost - cost to add one ground component

· High cost - incremental cost for substituting stairs/ladder on a composite play structure with a transfer system to a 24" deck
Under Alterations:
· Low cost -- no cost

· Medium cost - cost to add one ground component

· High cost - incremental cost for substituting stairs/ladder on a composite play structure with a transfer system to a 24" deck
Under Barrier Removal:
· Low cost - cost to add a transfer system to a 24" deck

· Medium cost - cost to add one ground component

· High cost - cost to add both transfer system and one ground component
Medium sized playground: Under New Construction:
· Low cost -- no cost

· Medium cost - cost to add two ground components

· High cost - incremental cost for substituting stairs/ladder on a composite play structure with a transfer system to a 36" deck plus the cost of adding one additional ground component
Under Alterations:
· Low cost -- no cost

· Medium cost - cost to add two ground components

· High cost - incremental cost for substituting stairs/ladder on a composite play structure with a transfer system to a 36" deck plus the cost of adding one additional ground component
Under Barrier Removal:
· Low cost - cost to add a transfer system to a 36" deck

· Medium cost - cost to add two ground components

· High cost - cost to add both transfer system and two ground component
Large sized playground: Under New Construction:
· Low cost -- no cost

· Medium cost - cost to add four ground components

· High cost - incremental cost for substituting stairs/ladder on a composite play structure with a ramp to a 12 or 16" platform from grade
Under Alterations:
· Low cost -- no cost

· Medium cost - cost to add four ground components

· High cost - incremental cost for substituting stairs/ladder on a composite play structure with a ramp to a 12 or 16" platform from grade
Under Barrier Removal:
· Low cost - cost to add four ground components

· Medium cost - cost to add a ramp

· High cost - cost to add both a ramp system and four ground components
Accessible routes to play components:

For small play area, sq ft to be covered:

New construction -308 (low, medium and high);

Alterations - low, 0; medium 70; high, 308,

Barrier removal 50, 70 or 120 (low, medium and high).

For medium play area, sq ft to be covered

New construction -710 (low, medium and high);

Alterations - low, 0; medium 140; high, 710;

Barrier removal 50, 140 or 190 (low, medium and high).

For large play area, sq ft to be covered

New construction -1,095 (low, medium and high);

Alterations - low, 0; medium, 280; high, 1,095;

Barrier removal 50, 280, or 330 (low, medium and high).

I. Operation and Maintenance Cost

These two tables present the Operation and Maintenance (O&M) costs. The first table lists general O&M costs by category or type of equipment. The second table applies these costs to specific elements in terms of the incremental O&M costs per element due to the requirements. Costs continue for 40 years.

1. Operational Guidelines for Grounds Management 2001 - Association of Higher Education Facilities Officers; National Recreation and Park Association; Professional Grounds Management Society

2. Maintenance Staffing Guidelines for Educational Facilities 2002 - Association of Higher Education Facilities Officers

3. Stewardship of Federal Facilities 1998 - National Research Council

4. Investments in Federal Facilities 2004 -- National Research Council

5. Benchmarks IV Research Report Number 25 2004 -- International Facility Management Association

6. Facility Management Handbook 2nd Edition 1999 - David G. Cotts,

7. Proprietary Corporate Facility Management Benchmarking Information

[1] As applied to public or private facilities that comply with ADAAG's transient lodging provisions, which are more stringent than the new (less stringent) requirements for dwelling units.

[2] As applied to public dwelling units that comply with UFAS, which is less stringent than the new (more stringent) requirements for dwelling units.
Source: Prepared by McKnight Associates using above-noted documents, and adjusted for selected requirements as follows: 1) zero O&M costs were assigned to those requirements which would not have any incremental O&M costs (above table); 2) O&M costs for requirements #2 (Maneuvering Clearance or Standby Power for Automatic Doors), #15 (Power-Operated Doors for Platform Lifts), #16 (Alterations to Existing Elevators), and #17 (Platform Lifts in Hotel Guest Rooms and Dwelling Units) were decreased slightly to reflect only the incremental costs of adjustments to existing elements; and 3) the O&M costs for #27, (Ambulatory Accessible Toilet Compartments) was increased slightly to reflect unit maintenance of added elements.
J. Facility Space Cost

This chart lists those facilities in which it was determined that the requirements which have a change in productive space that would directly impact sales/revenue. Space values for non-office facilities are calculated using construction cost per sq. ft. for facility scaled by the ratio of income per SF of office space to construction cost per SF of office space. The 2005 Construction Cost per square foot estimates from RS Means are escalated to 2009 estimates using the U.S. Bureau of Labor Statistics' Producer Price Index for New Construction. Only facilities that list a space cost proxy are assumed to have sales revenue impacted by a change in productive space brought about by the requirements. The space costs per facility listed here are the assumed most likely costs, the high and low costs are plus and minus 20 percent of the most likely costs.

Note that for the Valet Parking requirement (Req. # 20), approximately one-fifth of the space cost proxy is used, since the space cost proxy represents the value of space inside the related facility, rather than the value of parking spaces.
Source: Calculated using RSMeans Square Foot Costs, 2005 and The Building Owners and Managers Association (BOMA) 2006 Experience Exchange Report: U.S. Office Market Highlights.
K. Changes in Productive Space Per Requirement

This table shows the amount of space (sq ft) that is an incremental change brought about by these requirements. Changes in productive space are included only if the change is likely to have a direct impact on sales/revenues. Other requirements not listed here are assumed to have zero impact on productive space.

L. Years Before Replacement

Most elements should last for the life of the building (which is assumed to be 40 years). Those that do not are noted below. It is assumed that the replacement costs for these elements are 100 percent of the alterations costs. For the requirements which are assumed to be replaced more than every 40 years, the most likely year before replacement value is shown below. The high and low values are assumed to be plus and minus 10 percent of the most likely value.
Source: HDR and The Austin Company.
M. Transaction Costs

In response to public comments, this Final RIA includes a stress test that assesses the relative impact (per facility group) of including a cost element that monetizes estimated indirect costs for facility owners or operators to read the Final Rules or technical assistance materials in order to determine whether there are elements at their respective existing facilities that are subject to change under one or more supplemental requirements. This indirect cost is analyzed in the sensitivity analysis, Section 6.3. The value of time of a facility owner is measured by the U.S. Bureau of Labor Statistics' average hourly wage for a management occupation. In May 2008, this was found to be $48.23.

N. Example of Cost Estimation

This section presents individual calculations of the costs resulting from the Final Rules implementation at indoor service establishments. The results presented here may not match those in the Final RIA due to rounding.

According to the 2007 Economic Census, there are 3.8 million indoor service establishments.

The following eight requirements are assumed to be present in a typical indoor service establishment and will require a change to become compliant.

Costs are calculated for barrier removal, alterations and new construction each as described above:

Cost = [# of facilities]*[# of elements per facility] * [likelihood of a requirement at facility] * [unit cost per element]

Where the subscripts are defined as:

i denotes the facility;

j denotes the type of construction;

k denotes the type of requirement; and

l denotes the category of cost (capital, O&M, productive space, or replacement).

The components of this equation are listed below.

Note: Negative costs are cost savings.

For the first requirement listed, Door and Gate Surfaces, for indoor service establishments, the equation is as follows:

Total Capital Cost = [(3.8 million indoor service establishments * 1 Element per Facility * 25% Likelihood of Occurrence * $0 BR Costs * 50% of elements being readily achievable)] * 0 Safe Harbor Factor + (3.8 million * 1 * 25% * $0 Alt Costs * 2% of existing buildings being altered) + (3.8 million * 1 * 25% * $310 NC Costs * 0.2% of existing buildings are newly constructed) = Total Capital Cost = $0.59 million

Repeating this calculation for the other seven requirements at indoor service establishments yields $170 million in capital costs. Although some requirements have a BR cost for compliance at indoor service establishments, in the primary baseline scenario safe harbor is assumed and these costs are dropped out.

Note: Negative costs are cost savings.

The next costs to consider in the total cost estimate for these eight requirements are the recurring costs, O&M and loss of productive space. O&M costs, as described above, are commonly expressed as a percentage of the capital construction costs and are applied to each type of construction cost. These annual O&M costs are estimated by multiplying the O&M percentage of capital costs by each type of total capital construction cost.

The other recurring cost to facilities is the loss of productive space. The value of space for indoor service establishments is assumed to be $18 per square foot (sf). Each element is assumed to either impact the productive space of all facilities or not. For indoor service establishments, the water closet clearance in single user toilet rooms - out swinging doors is assumed to take away, on average, 6.4 square feet in barrier removal and alterations. In new construction, this requirement can save 0.6 square feet of productive space. The cost of lost productive space is calculated by multiplying the estimated space impact per requirement times the number of elements in each facility times the likelihood of a requirement at the facility times the number of facilities.

Note: Negative costs are cost savings.

All of the elements facing construction costs at indoor service establishments are assumed to not need replacing during the 40 year lifecycle of a building.

The annual total cost for all indoor service establishments is the sum of total construction costs, total space costs, and total O&M costs.

Annual Total Cost = Construction costs + Space costs + O&M costs + Replacement Costs = $170 million Construction + -$22 million Space + $0.2 million O&M + $0 Replacement = $148 million

The present value of total annual costs for indoor service establishments over the 40 year planning period is $2.2 B. The net present value of costs and benefits for indoor service establishments is $1.8 B.

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The ADA Home Page provides access to Americans with Disabilities Act (ADA) regulations for businesses and State and local governments, technical assistance materials, ADA Standards for Accessible Design, links to Federal agencies with ADA responsibilities and information, updates on new ADA requirements, streaming video, information about Department of Justice ADA settlement agreements, consent decrees, and enforcement activities and access to Freedom of Information Act (FOIA) ADA material

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Reason 1: Gender segregation has been around for a long time.

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Reason 1: Gender segregation has been around for a long time.

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Public restrooms have been gender separated for a long time, since about the 1700s. Although, gender specific restrooms have been around for a very long time, since the first restrooms in Rome, but laws about gender segregated bathrooms didn't appear until 1887. The first law was established in Massachusetts, requiring separate male and female bathrooms.

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Why Do We Have Men's and Women's Bathrooms Anyway?

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Though laws about bathroom use by transgender people have sparked new debate, the roots of bathroom sex segregation go back over a century

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Many people oppose these bathrooms because they can accommodate everyone. People can feel uncomfortable in these bathrooms. Most of the time, this discomfort stems from sexism and transphobia.

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First Words

Credit... Illustration by Javier Jaén. Wood surface: Northlightimages/iStock/Getty Images.

The clearest visual markers of sex difference many of us see in the course of the day are the signs on public bathroom entrances: MEN on one door, WOMEN on the other. Restrooms are public conveniences, freely available in most places and in principle open to all, but the terms for entering them have been fixed. They're fundamentally fraught spaces, where we undress and obey the dictates of our bodies and therefore feel vulnerable. If people think you've confused male and female and walked through the wrong door, you risk discomfort, or even real trouble. This can lead to the spectacle of women standing in line for what feels like forever while the men's room is empty. Now transgender people, most prominently, are asking society to rethink all of this, from signs to design to who gets to enter where.

Many people viscerally resist the idea of mixing male and female anatomy in multistall bathrooms and locker rooms. In Houston earlier this month, voters rejected a broad equal rights ordinance that protected against discrimination in housing and employment, as well as public spaces, on the basis of several categories, including age and race along with sexual orientation and gender identity. Opponents focused their campaign narrowly, nicknaming the law the ''bathroom ordinance.'' They created ''No Men in Women's Bathrooms'' T-shirts and a TV ad with sinister images of a man threatening a girl in the stalls, successfully playing on voters' fears.

School districts throughout the country have generally agreed to call transgender students by their preferred names and pronouns, and allowed them to join the sports teams of the gender with which they identify. But deciding where they should change and shower and use the bathroom has been trickier.

In suburban Illinois, a transgender high-school student who is undergoing hormone therapy and has a passport identifying her as female asked to change in the girls' locker room. The district refused, saying that ''privacy concerns'' required sending her to a separate room down the hall. She and her family brought a civil rights complaint, and the United States Department of Education intervened earlier this month, asking the district to give her the right to shower and change in the same locker room with her female peers. A privacy curtain could address both her needs and other students' concerns, the Education Department said - as long as other girls are also allowed to change behind the curtain, if they choose.

A word that comes up frequently in discussions about access to bathrooms is ''accommodate,'' and it is a telling one. ''Accommodate'' comes from the Latin for ''to make fitting.'' It means to adapt, to bring into agreement or harmony, to furnish with something desired or needed, to favor or oblige. It can be a word of welcome and hospitality coming from a concierge or maître d'. But it can also have a compulsory aspect - it's a word that involves moving over to make room for other people, whether you want to or not. In the 1960s, Congress gave religious people a right to reasonable accommodation at work, like a place to pray, or time off on the Sabbath, or permission to wear a turban or kipa or hijab. In 1990, the Americans With Disabilities Act afforded a similar right to people who had been shut out by doors they could not open and stairs they could not climb. For them, fighting for accommodation in bathrooms was central. If you can't get into one and use it, you can't work in a building or go to a concert.

Activists for all manner of marginalized groups have chafed at the word ''accommodation.'' It often sets up a distinction between the normal and the other. One group's needs determine a basic shape, and then another group comes along and asks to alter the contours. But the word also allows for the possibility of mutual give and take. ''It implies a two-way street,'' says Mara Keisling, co-founder and director of the National Center for Transgender Equality. ''Having a civil society is all about accommodation. Any relationship demands that.'' She thinks transgender people have been doing all the accommodating when it comes to the bathroom. But for a lot of people, the transgender bid to reconsider norms - the vocabulary, a girl who has a penis - has burst into the public consciousness quickly, and seems bewildering.

However natural separating men and women in the bathroom may seem, it's a cultural creation, with its roots in the Victorian era. States started to require sex-segregated ''water closets'' in the 19th century, when women entered spaces that men previously dominated, like factories, parks and libraries. Privacy and sanitation justified partitioning those early and rudimentary bathrooms; so did concern for the ''weaker body of the woman worker,'' as the University of Utah law professor Terry Kogan points out in an article on the history of sex-separated public bathrooms. Shopgirls got ''retiring rooms'' out of concern that they were prone to dizziness and fainting. Outside the home, beyond the bounds of the cult of domesticity, women supposedly needed a haven. But it was an exclusive one. When government offices integrated in the 1940s, some white women refused to share bathrooms with their black co-workers, claiming they would catch syphilis from towels and toilet seats.

Today women curse the time wasted waiting for a stall, while on the other side of the wall, urinals keep the line moving for men. (We could see the urinal as an accommodation for the male body, but we treat men as the norm, so we don't.) Some feminists see this lack of parity as a problem of ''everyday sexism,'' as the writer Soraya Chemaly put it earlier this year. The sociologist Erving Goffman pointed out that the environment in a women's room is expected to be more refined and genteel than that of a men's room, a relaxing ''all-female enclave.'' It also establishes ''a sort of with-then-apart rhythm'' for the sexes, with periods of intermingling among men and women punctuated by moments of separation.

Over time, women have become attached to the camaraderie of the ladies' room. When girlfriends want to chat, they head there. And now some of them are disturbed by what they see as an incursion by male anatomy. That's their explanation for the ''No Men in Women's Bathrooms'' T-shirts in Houston, and the resistance to letting transgender students into the locker room. It's poignant: Transgender women say they are women, but some other women can only see them as men, and so they don't want to make room. ''I am a bleeding-heart liberal - but in this new development I can't help but feel that people with two X chromosomes are once again having their rights pushed aside to accommodate people with a Y and X chromosome,'' a commenter wrote in The Times's Motherlode blog.

The problem is that this vastly oversimplifies the experience of transgender people and the biology of chromosomes, which can appear in other combinations. There is a spectrum of male and female, and no one definition of accommodation. Some people, transgender or otherwise, like single-stall bathrooms that are unisex (or all-gender, the word that's lately in favor). Maybe they want more privacy or their bodies take an unusual shape for any number of reasons. But for transgender girls, the locker room and the bathroom are about joining the all-female enclave, about fitting in. ''I just want to be with the girls at all times,'' a 12-year-old transgender girl in Connecticut told me. Her coed school, where she started this year, lets her use the girls' locker room. She showers in her underwear, which other girls her age do as well. ''I don't walk into the changing room and feel like, Oh, my God, I can't believe I'm here. It feels just as natural to be in there with girls as it does to be in the classroom with boys and girls.'' She recently started revealing her full gender identity to the friends she has made this fall. It has been a little scary, she said, but so far, they haven't pulled away.

The framework of accommodation is useful, as a starting place, because it's practical. For people with disabilities, reasonable accommodation is about a bar next to the toilet and a button that opens the door. For transgender kids, it's showering near your peers in your own stall, and then maybe getting dressed behind a privacy curtain. (Other girls with their own reasons for shielding their bodies from view might welcome a curtain, too.) It's about relatively small adjustments for the sake of coexistence.

It doesn't seem like much compared with the self-contorting accommodations that the public bathroom can demand of transgender people. The Transgender Law Center offers a resource guide, '' Peeing in Peace,'' with a variety of strategies for going into the restroom of your choice. One is called Invisibility: ''Don't look at or speak to anyone.'' Another is called Gender Proof: ''Try pointing out your physical characteristics if they will help prove that you belong. For example, if you have breasts, try pointing them out to prove that you belong in the women's room. If you have a deep voice, try speaking to show that you belong in the men's room.'' The ache lies in the word ''belong'' - another basic human need we all share.

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Making Bathrooms More 'Accommodating' (Published 2015)

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First Words The clearest visual markers of sex difference many of us see in the course of the day are the signs on public bathroom entrances: MEN on one door, WOMEN on the other. Restrooms are public conveniences, freely available in most places and in principle open to all, but the terms for entering them have been fixed.

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Reason 2: People aren't aware that it is an issue.

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Reason 2: People aren't aware that it is an issue.

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Many people are not aware that the lack of all-inclusive bathrooms is an issue because it doesn't effect them. Most people also don't actually understand people with disabilities, who are transgender, etc. This can lead people to thinking that it isn't an issue. Lastly, many people are not aware that this is an issue because it's a relatively new concept. If people aren't aware of an issue, then nothing gets done to solve it.

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Several years ago, a desperate mom posted this question to the Yahoo! answers forum:
Where/how can I change my disabled 10 yr old diaper in public? Too big for typical changing table? I have a 10 yr old daughter with CP in a wheelchair. When we are out and about in public there is no place to change her diaper. She is too big for the typical changing tables. And even though we have a mat we could lay her on, there is usually no space on the floor big enough, without making it too "public" and embarrassing for her. Any solutions?
After receiving a number of responses, she amended her question:
Additional details: I know there are larger handicapped stalls. Actually, they are made for people who are in wheelchairs or walkers that can lift themselves to the toilet. You have to imagine enough space for me and the chair. Then enough space to lift a 55 lb child out and lay her on the floor. Then sit on the floor myself and change her, etc ... It is not as simple as "that is what the handicap stalls are for."
The answers she got missed the mark widely, no doubt in large part because the general public doesn't understand the problem. It's hard to fully comprehend the issues unless you're living them. Here's a couple:

A lot of wheelchair users can't transfer from their chairs unassisted. They need more than space for their wheelchair.

As this girl gets older and bigger, solutions like a mat on the public restroom floor, as unappealing as that is even now, will become completely impractical.

They may need diapering, not toileting, facilities.

Check out this video from Changing Places, an international organization working to address the problem:

Handicapped stalls in public restrooms accommodate the wheelchair. Not the person. Someone using a wheelchair may need to lay down for diapering, usually with the help of a personal aide or attendant. The current standard for wheelchair access to public restrooms doesn't come close to addressing the full scope of needs. So what's the answer?

The family, or universal, restroom. Also known as single-stall restrooms. You may have begun to see them in airports, museums, and hotel lobbies - usually adjacent to the traditional 'Mens' and and 'Womens' - a separate facility which accommodates changing a baby, breastfeeding, parents attending children of the opposite sex, and more extensive incontinence requirements.

Here's the rub - or one of them anyway. They are rarely equipped to handle the spectrum of needs for people using wheelchairs. They should include height adjustable changing tables large enough to accommodate adults, height adjusting sinks, perhaps even mechanical hoists.

My hope is that all public venues, from movie theaters and shopping malls to stadiums and recreation facilities, will step up and provide not only a family restroom but the proper equipment for anyone who needs them. The 2003 International Building Code, adopted by several states, requires family restrooms in new construction and substantial renovation. Forward thinkers in Ontario, Canada recently updated the building code to include broader accommodation, including adult change tables.

Families today are varied, multi-generational, mobile, and social. Let's make sure everyone is included wherever they want to go.

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Family Restrooms -- So everyone can go when they need to. MAX-Ability

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Several years ago, a desperate mom posted this question to the Yahoo! answers forum: Where/how can I change my disabled 10 yr old diaper in public? Too big for typical changing table? I have a 10 yr old daughter with CP in a wheelchair.

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Parents are pushing for inclusive bathrooms.

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Parents are pushing for inclusive bathrooms.

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Parents with children, disabled or not disabled, can find it difficult to take children into public restrooms. Some restrooms don't have (proper) changing tables, are not a private space, and the opposite or different gender in a bathroom can make other people uncomfortable. An important aspect of these bathrooms is that they are big enough to accommodate universal changing tables. Parents are pushing for these bathrooms to provide better care for their children.
Another Resource:
https://tinyurl.com/a1342d

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Like many mothers, Brookfield resident Sarah Knowles wants to make sure her son Matthew has a good life. She takes him to the zoo and public museum. They have season tickets to the Milwaukee Wave. She takes him horseback riding and rock climbing.

But Matthew, 20, has cerebral palsy and a chromosome disorder, making many of these activities difficult at times. Factor into the equation that Knowles has to plan bathroom breaks into their trips, often causing stress and anxiety for both her and her son.

If a building doesn't have a low enough changing table or an adult-size changing station, they often aren't able to spend much time there. Knowles said they can use the back of their van in the summer, on occasion, but in the winter it's often too cold to change Matthew in the back of a van.

It's gotten so bad that Knowles even considered buying a season pass for the Discovery World Museum, just so they could use the changing table there when they're in downtown Milwaukee.

"Matthew's 20 years old. He doesn't want to be sitting home for the rest of his life, only going out for two- or three-hour periods," she said.

That's why she's been advocating for more than four years to add adult-size changing stations at more buildings, stadiums and venues across the state and the nation.

But Knowles said she's not just advocating for this change to make her life easier. She's advocating to make it easier for the many families nationwide who care and tend for those with physical disabilities.

"People don't realize it's a problem if they don't have that situation," Knowles said. "Even people who I have known for years. When I took this on, they said 'we never even thought about that.' "

Knowles, who works closely with the group Changing Spaces, decided to push for state legislation to address the issue. When State Rep. Robyn Vining (D-Wauwatosa) was elected, Knowles said she reached out "literally the second she got inaugurated."

Knowles and Vining met shortly after Vining took office in 2019. Knowles shared many of the stories she has collected over the years, including one time that Matthew had to be changed in a storage closet at a Special Olympics event in Wauwatosa.

Vining quickly decided she would take this on. She said it is a question of human dignity and public health.

"We have a population of people in need who are going unseen," Vining said. "I think they deserve to participate in society."

In December, Vining announced the bipartisan "Universal Changing Stations" bill calling for installation of adult-size changing stations in certain buildings and to incentivize smaller businesses to install the stations.

Some of the buildings would include malls, schools, libraries, stadiums, concert venues, museums and zoos.

The changing tables in the stations would be height adjustable so they could lower to wheelchair height so people who can't weight bear could slide across. They could also be raised to working height to prevent caregiver injury and would have safety rails to prevent the user from rolling off, Knowles said.

Knowles said the idea for legislation similar to Wisconsin's started in 2006 in the United Kingdom with a grassroots movement that was inspired by Changing-Places UK. Since then, the idea has come to the United States, and grassroots groups now exist in about half of the states.

Knowles said the stations could also be used by adults who have multiple sclerosis, are suffering from the after effects of a stroke, the elderly or more.

Ideally, Knowles said, she is hoping a federal mandate for the changing stations is created soon. But because of Knowles' advocacy here, various spaces in Milwaukee have already installed adult-size changing tables, including Fiserv Forum, UW-Milwaukee Panther Arena, Milwaukee County Zoo, Summerfest and Discovery World.

Mitchell International Airport and Wisconsin State Fair Park have announced they will be adding adult-size changing tables within the year.

In the long run, Vining said, she thinks more adult-size changing stations will benefit businesses because more people will be able to visit those businesses.

"If people can visit your building and spend money in your building, then that is a benefit to your building," she said.

Knowles agrees.

"A lot of people have said, 'we don't see people like Matthew in our venue,' but that is probably because if you've got a medical condition sometimes it's too overwhelming," Knowles said.

Vining doesn't have a timetable for the bill yet, but she's excited it's gaining traction. She said she's heard from many more people across the state who share Matthew's struggle.

"Legislation is important. But Sarah's advocacy is really important. This is the way that democracy is supposed to work," Vining said.
Evan Casey can be reached at 414-403-4391 or evan.casey@jrn.com. Follow him on Twitter @ecaseymedia.

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This Brookfield mother is fighting for more adult-size changing stations across Wisconsin

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Like many mothers, Brookfield resident Sarah Knowles wants to make sure her son Matthew has a good life. She takes him to the zoo and public museum. They have season tickets to the Milwaukee Wave. She takes him horseback riding and rock climbing.

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Stalled! is a group of experts on the International Pluming Code and creating

All-Gender Public Restrooms that are also accessible (practically inclusive bathrooms). This group is focusing on tackling bathroom-relating social justice issues.

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Architects and Designers Just Helped Win a Major Victory for All-Gender Public Restrooms

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In recent years, the push for all-gender public restrooms has been making legal headway throughout the U.S. But even people well-versed in the matter may not be familiar with the International Plumbing Code, a written document that helps set standards throughout the industry.

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The SBAC is working to solve real world issues that people who are transgender deal with on a regular basis. One of this issues they are working to solve, is having proper, safe access to a public bathroom.