A new paper published in the New England Journal of Medicine outlines the reasons why equal access to public bathrooms is critical to public health, and how lack of safe public accommodations can lead to serious injury and illness for transgender people. The paper, titled Beyond Bathrooms — Meeting the Health Needs of Transgender People, was co-authored by Dr. Sari L. Reisner, Sc.D., Research Scientist at The Fenway Institute.

The debate and passage of recent legislation in several states to require people to use the bathroom corresponding with their “birth” sex has led to much fear and misinformation. Claims that equal access to public restrooms will be abused by sexual predators to prey on women and children have been used to paint transgender people as dangerous, when in fact it is transgender and gender non-conforming people who are overwhelmingly the ones suffering physical and emotional harm in these restrooms.

“Transgender people who are barred from using bathrooms where they feel safe might feel they have no choice but to suppress basic bodily needs,” the paper explains. “Delayed bathroom use can cause health problems including urinary tract or kidney infections, stool impaction, and hemorrhoids. Some transgender people even abstain from drinking during the day to avoid the need to urinate.”

When transgender people do use public bathrooms, they often put themselves at risk of being attacked.”When transgender people are physically assaulted in public bathrooms, they may suffer bruises, broken bones, or worse. In addition, the ongoing fear of harassment and violence when using public bathrooms can take a toll on mental health,” the paper adds.

Health care providers can play an important role in making the world a safer place for transgender and gender non-conforming people. Staff in health care facilities such as hospitals, doctor’s offices, and clinics should be trained in transgender competency to ensure that all patients receive quality, compassionate, and respectful care. More researchers are focusing on the unique health needs and challenges of the transgender community, collecting data that is critical to improving universal care for this community. And, in the case of public accommodations debate, doctors are often being called upon to be advocates for transgender people and their health.

“Discrimination facing transgender people occurs in multiple settings, including in health care contexts. Discrimination is not only unjust–it also harms health,” said Reisner. “The medical community has a pivotal role to play in meeting transgender health needs. This role includes not only provision of high quality gender-affirmative clinical care, but also support for anti-discrimination advocacy efforts to protect transgender individuals and communities.”

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