If a person has to go to the bathroom while out in public, it may be difficult to find a toilet without some sort of catch. Often, it’s in a coffee shop, a convenience store, a pharmacy, or another private building, so it’s not a true public toilet.

The U.S. has eight public toilets per 100,000 people. That number is comparable with the rate in Botswana and far behind Iceland’s world-leading 56 public toilets per 100,000.

So why is it so hard to find a public toilet in the U.S.?

It’s a question with a complicated answer, and that has a long history. Surprisingly, it relates to many different issues, including public health, social services, and almost every form of discrimination imaginable.

Public toilets were a fact of life in the U.S. and elsewhere for centuries — at least as far back as the Roman Empire. But they were pretty public, without any walls or barriers between them. The expectation for privacy while going to the bathroom in a public space emerged in the 19th century, with the industrial revolution and houses with modern plumbing.

Later on, in the 19th century and into the early decades of the 20th century, sanitation became a greater priority. As leaders began understanding sanitation's role in containing outbreaks of waterborne diseases, cities built and celebrated their public toilets.

Temple University history professor Bryant Simon, who has studied and is writing an upcoming book on the history of toilets, shared more about how toilets used to be a big deal.

"City officials get on their soapboxes and brag about how much they spend on public bathrooms," Simon said. "They brag about the touch points in these bathrooms. They brag about the brass fittings. They brag about the marble countertops. They brag about the floors. They're proud of their accomplishment."

Bathrooms quickly became points where people were segregated. Bathrooms were split up by gender, as they still frequently are. But the splits can be broader than that and lead to discrimination against many different groups.

For example, public toilets started closing as early as the 1930s, with the LGBTQ community as a target.

"Beginning in the 1930s, 1940s, that early, public officials begin to complain about perversions," Simon said. "They begin to complain about same-sex sex in bathrooms. As there are fears about gay sex in bathrooms, there's fear about people drinking in bathrooms. It's not a very popular city sort of thing to build anymore."

In the first half of the 20th century, bathrooms often were segregated by race, with Black Americans, or Latinos in the Southwest, having their own separate facilities.

"The bathroom sort of operates as a kind of hardware of inequality because, essentially, you needed a public bathroom or a bathroom of some sort in order to be out and in public," Simon said.

Racial segregation in toilets may sound like a distant thing or a footnote, but that legacy extends into the present.

In 2018, two Black men were blocked from using the restroom at a Starbucks location in Philadelphia’s Center City. The incident prompted Starbucks to act as America's de facto public toilet. It changed its policy to allow people to use the restrooms at its more than 15,000 U.S. locations without buying anything.

While money can be a barrier to private toilets in stores, historically, it’s limited access to public standalone toilets. By the 1960s and '70s, public toilets requiring small payments sprung up, but those ended up closing after concerns about gender discrimination.

The other big push to remove public toilets came in the 1980s as part of a broader push to drive unhoused people to the edges of cities by taking away their access to public spaces and aggressively enforcing public urination laws.

Now if you don’t have a home of your own, it can put access to a restroom pretty far away.

"Most of us are used to having our own bathroom," said Raven Drake, Street Roots ambassador program manager. "Where I lived when I was unhoused, the nearest bathroom was a one-mile walk away. Imagine walking a mile to the bathroom, and most of us can't fathom walking 50 feet to our bathroom, much less a mile."

Drake works with unhoused people in Portland as part of the local newspaper Street Roots. She’s an advocate for bathroom access as a central part of addressing homelessness, and she was unhoused herself in late 2019 and early 2020 during some of the strictest shutdowns of the COVID-19 pandemic.

"We ran a survey around bathrooms, around the importance of bathrooms and access to clean water with the Joint Office of Homeless Services, and a resounding amount of people answered that they had no access to public restrooms," Drake said. "So we took forth on this initiative of placing throughout the city 172 port-a-potties."

Underinvestment has been a major concern, too. If public toilets aren’t funded or attended to, they can fall into disrepair. They can potentially become unsafe or unhygienic.

Starbucks announced in July that it would close 16 stores due to safety concerns. CEO Howard Schultz said in June that the coffee giant might restrict its currently public restrooms to customers only as part of its broader push for store safety.

So, if Starbucks decides to no longer serve as America’s public restroom, where will people be able to go? Even if a person isn't homeless, bathroom access advocates like American Restroom Association president Steven Soifer point out this is an issue.

"For everyone, for people with shy bladder, for people with incontinence, for people with bladder issues of different sorts," Soifer said. "People who had health issues and families with children who often struggle to find a place."

Soifer is calling on government officials to step up here, but it may have to be local officials taking the lead.

"There are going to be fewer and fewer options for people to be able to relieve themselves, and that becomes a public health issue as well," Soifer said.

The consequences can be deadly for communities if no bathrooms are available. In 2017, at least 16 people died, and hundreds more got sick in San Diego in an outbreak of hepatitis A.

The disease spread largely due to contact with fecal matter and public defecation.

The city acknowledged that a lack of public restrooms, especially for unhoused people, was part of the issue and helped contain the outbreak by installing public toilets and handwashing stations.

But even then, a lack of funding or upkeep can quickly lead to toilets disappearing. Earlier this year, San Diego State University researchers reported that many toilets were closed after the COVID-19 pandemic. That nearly half the county’s census tracts, home to 40% of the population, had no public restrooms.

Other cities are moving ahead with plans to install new public toilet facilities, including Portland, Philadelphia, and Washington, D.C. But there’s still a shortage of public toilets in the U.S., and it’s pretty dire.

In 2011, a United Nations independent expert, Catarina de Albuquerque, studied water and sanitation rights on a mission to the U.S. Her report found an instance in Sacramento, California, where public restroom closures and enforcement of public urination and defecation laws led to a homeless person traveling miles to dump a whole community’s human waste.

In the report, she indicated that the laws had a discriminatory effect and led to "a violation of human rights that may amount to cruel, inhumane or degrading treatment.”

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ALBUQUERQUE, N.M. —

Nan Zhang came to America 15 years ago, became a citizen and decided she wanted to serve her new country.

“So my ultimate goal (was to) become APD police officer,” said Zhang who was originally from China. “It's (to) protect my community."

But her plans to become an Albuquerque police officer were cut short, she says, when she was forced to resign. She claims in a lawsuit that she underwent abuse, discrimination and was has given the nickname “Cadet COVID.”

"People kept telling me that you don't belong here,” Zhang said. “They tell me these things every day. This is harassment. I mean, it's just because of my age, my language and my race."

Now, Target 7 is being told that the Department of Justice has reached out to Zhang’s attorney.

Target 7 reached out to the U.S. Attorney’s office and they will not confirm or deny an investigation. APD says they don’t believe the DOJ is looking into Zhang's claims and in legal documents city attorneys denied that Zhang was pushed out of the academy and instead she voluntarily quit. City attorneys also denied any that any academy personnel discriminated against Zhang.

"I'm an American citizen, I'm American,” Zhang said. “And, my rights is equal like everybody else, but they treat me so different."

KOAT legal expert John Day said there is plenty of accusations for the DOJ to look at.

“The Department of Justice, that's one of their jobs,” Day said. “One of their missions is to investigate allegations of civil rights violations. The Department of Justice has an obligation to investigate. If they are in fact investigating, It means that they there is some information that they have that has led them to decide that we have got to look into this further.”

Zhang moved to the U.S. about 15 years ago. She eventually ended up in Albuquerque and decided to become a police officer after her home was broken into twice in the same week.

"I work out every day to try to meet the requirement for APD,” Zhang said.

Zhang tested and passed APD's physical agility tests and written tests with flying colors
She then interviewed with three high-ranking police officers — two deputy chiefs and a lieutenant- they all approved her to become a cadet.

In order to become a police officer cadets have to complete 26 weeks of training at the APD Law Enforcement Academy. Zhang had and finished six weeks before she says she was asked to resign.

In her lawsuit, she says academy personnel made her sign a resignation letter in which she says, “I was made to believe that she was quote — unfit for the role.”

Before Zhang signed that letter she says she went through weeks of what she calls "abuse."
She claims everyone kept telling her they couldn't understand her English.

Zhang hired retired Albuquerque police officer-turned attorney, Tom Grover to represent her. Grover himself graduated from the same academy

"What stood out to me when I looked at the records that Nan had when she provided her narrative of what occurred was how they were such a dwelling upon her while others were getting passes,” Grover said. “This was completely inappropriate and not consistent with the typical stress that a police academy is.”

Earlier this year the state's department of workforce solutions investigated her complaint and found no probable cause that the city discriminated against her.

Despite what she claims she went through Zhang says she still wants to be a police officer and serve her community.

"I really want to become a police officer, honestly,” Zhang said. “But I don't think they will accept the people who look like me. Look different. Talk different."

A Birmingham, Alabama, woman claims she was asked to leave The Southern Kitchen And Bar in the Uptown District over the shirt she was wearing. Aireal Bonner said she did not see a dress code policy posted inside the restaurant and one was not available when she requested it.

"I was approached by the manager, and she told me that the owner, which I actually found out was not the owner, had seen me on camera from his home and called in to ask her to approach me about my attire," Bonner said.

According to a local attorney, a private business has the right to refuse service to anyone as long as it does not discriminate.

Southern Kitchen and Bar released the following statement to WVTM 13 on Tuesday:

"The management of Southern Kitchen and Bar has reviewed the alleged racial discrimination made by Ms. Ariel Bonner from Friday, August 6th. The event in question centered around a manager observing her in what appeared to be a bikini top which is not consistent with our appropriate attire policy. As a family-friendly, neighborhood restaurant we have an appropriate attire policy in place to provide an experience that meets both our standards as a brand and our clientele’s expectations. In similar instances where attire does not conform to the standards, our staff strives to resolve the issues as politely as possible. Although a manager did approach her in a polite manner with an offer of a free Southern Kitchen and Bar T shirt to use as a cover up, Ms. Bonner was not approached until she had commenced eating her meal.

"We regret interrupting Ms. Bonner’s dinner and understand that would make anyone feel uncomfortable. We apologize for this. Clearly, the matter should have been discretely handled upon the patron’s entry into our restaurant. But we should also note the attempt to follow company policy was ill-timed but not ill-intentioned.

"We are establishing more rigid protocols to ensure all policies within our restaurant are upheld and are enforced by staff. We will make every effort to politely address them at the front door. We have done and will continue to do the work to ensure our restaurant is a place where all feel welcome."

Watch the video above to learn more about the story.

CHICAGO — When it comes to getting an organ transplant, people with intellectual disabilities continue to face barriers. Misconceptions about their ability to comply with post-op requirements sometimes mean doctors and transplant centers have refused to put them on waiting lists.

Charlie Robertson is a sweet, curious 5-year-old girl, who loves to pick flowers for her family. But Charlie, who has Down syndrome was born with a hole in her heart that didn’t close on its own.

“It was kind of always in the back of my mind that if she needed surgery, something went wrong, she needed a heart transplant, she may be denied,” said Charlie’s mother, Lindsay.

Physicians and hospital transplant teams make the determination as to who is a good candidate to be added to the national waiting list. But denying organ transplants to people with intellectual disabilities like Down syndrome or autism still happens even though it’s illegal.

One study reported that 85% of pediatric transplant centers consider intellectual or developmental disability as a factor in their determination of transplant eligibility, and 44% of organ transplant centers wouldn’t add a child with a neurodevelopmental disability to the list.

“There is still discrimination faced by people with disabilities for organ transplants,” said Ashley Helsing, director of government relations with the National Down Syndrome Society.

Helsing says families can file a complaint with the Health and Human Services Office for Civil Rights, but that takes time.

“And when a person is at the point where they need a transplant, time is absolutely of the essence,” said Helsing.

Earlier this year, Congress introduced federal legislation to expand protections in the Americans with Disabilities Act. It would prohibit organ transplant discrimination based on a person’s disability or their perceived inability to comply with postoperative care.

“Not many people with Down syndrome and those with IDD get the opportunity to have a life-saving organ transplant,” said Charlotte Woodward.

The proposed federal legislation is named for Woodward, a disability civil rights activist with Down syndrome who received a life-saving heart transplant nearly nine years ago.

“If my doctors hadn’t advocated for me to be a heart transplant recipient, I wouldn't be here,” said Woodward.

In the meantime, states are being lobbied to step in.

Texas recently joined 19 other states, like California, Ohio and Florida, that have passed laws ending disability-based discrimination on the organ transplant list. Another nine states, including Colorado, New York and Tennessee, have introduced similar legislation.

Lindsay Robertson worked to get a state bill passed in Illinois and on to the governor’s desk.

“As a mom, I feel like it's just one more thing that we have to fight for so that people know that it doesn't matter if they have a disability,” she said. “She's worth it. If she needs a transplant, she should be able to get one regardless of her diagnosis.

Video above: North Carolina student says she was forced to cut her braidsIt was her last home softball game of the season, and Nicole Pyles, a sophomore at Durham Hillside High School in North Carolina, had just hit a double. Her hair, braided with beads and tied in a bun at the bottom of her neck, was the last thing on her mind.It quickly, however, became a focal point of the April 19 game. First, a coach on the opposing team claimed they couldn't see her jersey number, Pyles said. Pyles, 16, said she tucked the braids into her sports bra and continued playing. But then, later that same inning, it came up again.A coach on the opposing team pointed out the beads to the umpire, Pyles said. Beads in hair, according to the rulebook, weren't permitted. So despite playing four prior games with the beads, the umpire gave Pyles a choice: Either take the beads out, or don't play."I asked why is this now an issue ... and he said it's a rule, there's nothing he can do," Pyles told CNN.So Pyles' said her teammates gathered around, attempting to take the beads out of the hair. Because they were wound so tightly, they had to cut some of the hair out in order to remove all the beads, Pyles said."I felt dehumanized," Pyles said.Now, Pyles' family is attempting to get the rule changed."Everyone's hiding behind the rules of the game," Julius Pyles, Pyles' father, told CNN. "If there was a rule, it should've been applied in the beginning, (not in) their last game."Rule is 'culturally biased and inappropriate,' school district saysPyles' experience is a familiar one.In one of the most famous examples, a Black high school wrestler in New Jersey was forced to cut his dreadlocks off in order to compete in a tournament, after being told his hair wasn't in compliance with league regulations.In 2020, another Black high school student was told that if he didn't cut his dreadlocks to comply with the district's dress code, he wouldn't be able to walk at graduation. And there have been similar incidents all across the country.Julius Pyles says he has reached out to multiple people with Durham Public Schools and the North Carolina High School Athletic Association. Though DPS has publicly supported Pyles, the NCHSAA has not. "Durham Public Schools supports our students' right to free expression and opposes unreasonable or biased restrictions on Black women's hairstyles," the district said in a statement Wednesday, regarding the April game. "We believe the blanket ban on hair beads is culturally biased and problematic. We support our student, Nicole Pyles, and believe this rule should be amended."The district went on to encourage the NCHSAA and the National Federation of State High School Associations (NFHS), of which NCHSAA is a member and thus dictating rules across North Carolina high school sports, to review the policy, calling it "culturally biased and inappropriate."Rule may be addressed next month, national organization saysBut Commissioner Que Tucker, of the NCHSAA, stated that the rule is "not new.""When the violation was noticed by an umpire, the proper determination of illegal equipment was verified as supported by NFHS Rule," she said in a statement to CNN. "Further, according to NFHS Softball Rule 3-5-1, prior to the start of a contest, it is the responsibility of each coach to verify to the plate umpire that all his or her players are legally equipped, and that players and equipment are in compliance with all NFHS rules."Tucker called the experience "truly unfortunate," but said the coach's duty is to ensure players are aware of the rules before playing.The rule regarding beads in hair was first enacted in 2012, according to Karissa Niehoff, executive director of the NFHS. It was instituted to "minimize the risk of injury" to athletes during competition, the organization said.Though the NFHS did not say if the rule would be amended, Niehoff did say the NFHS Softball Rules Committee will "address hair beads and other adornments at its annual meeting next month."The rule as it stands, though, is discriminatory, Julius Pyles said."It's 2021, and now my child is being a part of something that should be dead and gone. I didn't serve this country to then be discriminated against," said Julius Pyles, a veteran.