Good health is a primary human right, but not everyone is afforded it, or given equal access to it. Discrimination to good health on the basis of caste, religion, race, ethnicity, nationality, etc. is all too common even in our modern “progressive” world. Gender based discrimination in all arenas is something we are all too familiar with. Women are often misdiagnosed by the medical practitioners, primarily because practicing medicine for the longest time was dominated by the hegemonic patriarchs of the society, who had very little concern for the women’s biology. Much has changed since then, but still discrimination against minority groups of various identities and labels still lurks – not only in terms of direct access, but also in the arena of support systems, legislation and so on.

One of the most targeted groups for medical discrimination in terms of gender is faced by transwomen, and particularly transwomen of colour, and transwomen who strays away from the cisgender ideal of what a woman should look like. There are multiple baseless claims made against transwomen accessing public facilities and support centres for women. This essay will focus on troubles transwomen face with regards to these issues, and the medical consequences they suffer from as a result.

Brief Historical Background

Transwomen are not the first victim to the ‘restroom’ argument. Prior to them, in the United States of America and in other British colonies, bathrooms were segregated on the basis of race. Black and coloured people were considered a threat to the white populace. During the desegregation era in the 60s and 70s, political and social factions opposing desegregation often used desegregated restrooms as places the white people could be threatened by the other races. The same argument could be traced in Indian history in relation to caste-based discrimination. Though these particular scenarios are no longer a concern in the larger social psyche, the argument did not disappear in its entirety – instead, it merely found a new home to settle to. 

Human beings are particularly talented at othering anyone that they don’t agree with or cannot relate with. This was a major problem for the vast majority of the cis-het population during the 80s and 90s when queer movements were taking the centre-stage in both academia and social activist spheres. With a large section of people being mobilised by transwomen of colour such as Marsha P. Johnson and Silvya Rivera. The rise of trans-activists throughout the time period and bad faith fictionalised and incorrect portrayals of transwomen in general taking a major step in the pop-culture of the time with movies such as the acclaimed Psycho (1960), and The Silence of the Lambs (1991) dealt a major blow to the queer communities. These instances were influential in misrepresenting the trans experience to the general public, and thus stoked fear in the minds of the common populace. Transwomen were thus seen as men donning the clothing of a woman to prey on the “innocent women”.

Such, the effort to remove transwomen from women’s restrooms and safe spaces were met with frightening public favour and legislation for it was drawn upon; and its effects are still haunting the queer communities and its people.

Public Restrooms and Health

In the introduction of her essay, Gendered Restrooms and Minority Stress: The Public Regulation of Gender and its Impact on Transgender People’s Lives, Jody L. Herman aptly states, “Restrooms in particular are an integral and necessary part of the built environment for our daily lives. All people share the real human need for safe restroom facilities when we go to work, go to school, and participate in public life. Since the need is universal, one would think that it would be a priority of our society to make sure restrooms are safe and available for all people. Yet, the way gendered public restrooms are designed and constructed harms transgender and gender non-conforming people, some of whom may not inform to reified expectations of how men and women will look and act” (Herman, 2013).

The minority stress model Herman discusses in her essay refers to the various range of stressors that a person discriminatory experiences or disparate treatments a person may experience in their daily life. Since the majority of the queer identified individuals experience minority stress constantly, especially transwomen whose appearance deviates from the gendered expectations, it can cause severe mental health problems and social well-being (Herman, 2013). Further, instances of physical violence, and harassment leading to arrests were reported in a sociological study conducted around queer people and restrooms (Cavanagh, 2010). 

The combined effect of all these factors is that transwomen, even in the places where they are legally protected to use women’s public restroom facilities, avoid them so as to not subject themselves to harassment or violence. They even change their walking routes through places where they know they are absolutely safe, or else avoid the facilities altogether. Not using restrooms when they really need to due to minority stressors leads to the development of diseases such as Urinary Tract Infections (UTIs), kidney problems, and more. This is particularly dangerous to transwomen who have undergone bottom surgery, as they are easily prone to complications arising from infections, which at times could even be fatal. For a community with less than half the life expectancy of that of the general population, these concerns are extremely concerning to put it lightly.

Legislation and Other Issues Plaguing Trans Healthcare

There seems to be a major uptick in violence against transwomen of colour in many parts of the world, as they hold the least amount of social and economic capital compared to other minority communities. Further, legislation against transwomen from using public facilities for women is also on the rise. Their argument goes, cis-men could dress up in women’s clothing and masquerade as transwomen to access women only spaces so as to assault cis-women. But multiple studies show that is simply not the case. The biggest threat to cis-women are other cis-men. In fact, transwomen are even more vulnerable in women’s only spaces than cis-women.

In a literature review conducted by the Gender Recognition Act (GRA) by the UK Government in 2019 titled, Potential Impacts of GRA Reform for Cisgender Women: Trans Women’s Inclusion in Women-Only Spaces and Services, makes two important points: “No evidence was identified to support the claim that trans women are more likely than cisgender women to sexually assault other women in women-only spaces. This lack of evidence is reiterated by other sources”, and “This literature search did not identify any evidence supporting a link between women-only spaces being inclusive of transgender women, and cisgender men falsely claiming a trans identity to access these spaces and commit sexual violence. Other sources included in this search reiterate a lack of any evidence to support this claim” (GRA EQIA Literature Search, 2019).

Not only does this put a strain on transwomen, but it is also harmful to ciswomen as well. There are multiple recorded instances of ciswomen being misidentified as trans and are assaulted or harassed by police enforcement or other people in their immediate vicinity. These stringent rules on gendered bathroom policy forces masculine looking transmen to use women’s restrooms, which further exacerbates the issue.

Conclusion

Trans people have always had it tough when it comes to navigating the complex gendered rules and hierarchies of our deeply patriarchal and at times “archaic” world. It is all the more highlighted by the seemingly trivial issues such as trans bathroom hurdles. They put their lives at risk everyday not just from lynching and violent assault, but also from health complications that arise from denied a basic human need such as urinating when they are outsides the confines of their home. The legislations on women’s health mostly controlled by cis-het men ignore and deny the needs of the others; and that is nowhere more apparent than it is when it comes to transwomen and their right to use gendered spaces.

Further, more transwomen and women of minority communities should be consulted and included in the decision making process about their health. The legislatures should also rely on the latest sociological and scientific literature on their issues rather than making legislations based on rhetoric.