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Up to 46 Million with Debilitating Shy Bladder Syndrome - Gang Restrooms

  • 1.  Up to 46 Million with Debilitating Shy Bladder Syndrome - Gang Restrooms

    Posted 04-26-2017 15:05

    Per Wikipedia, 14.4% of the population has shy bladder syndrome (paruresis) finding it difficult or impossible to use gang restrooms. 

    A 1954 Study by Williams and Degenhart found 14.4% of the population having paruresis equaling 46 million Americans based upon 2015 USA population of 320,090,857.  1998 Harvard University Study found 6.6% of the population having paruresis equaling 21 million Americans as of 2015. 

    Employment, commerce, productivity, safety and well being are being compromised in a major way.  People must be able to use the restroom in buildings or they will try and avoid them.    

    Correlation to Unemployment? 

    • 93 million Americans are out of the workforce;
    • 7 million American men between ages 25 and 54 are not seeking work (Nicholas Eberstadt – Men Without Work);
    • 45.7 million Americans are on food stamps.

    Shy bladder syndrome would have to be a considerable percentage of these numbers.  This debilitating condition affects too many people for it not to be the case.  

    Architects to the Rescue

    The 2018 International Plumbing Code A Plumbing Code allows all restrooms (and bathing rooms) to be designed gender-neutral and single-occupancy.  It includes the family or assisted-use toilet fixtures to satisfy the total fixture count in all occupancies instead of just assembly and mercantile per the 2015 code -

    2018 International Plumbing Code 403.1.2 (mirrors to the International Building Code IBC 2902.1.2) 

    Single-occupancy toilet facility and bathing room fixtures.

    The plumbing fixtures located in single-occupancy toilet facilities and bathing rooms, including family or assisted-use toilet and bathing rooms that are required by Section 1109.2.1 of the International Building Code, shall contribute towards the total number of required plumbing fixtures for a building or tenant space. Single-occupancy toilet facilities and bathing rooms, and family or assisted-use toilet and bathing rooms shall be identified for use by either sex.

    Variances, modifications or State Code Committees can allow this 2018 code in advance.

    Adding a family toilet room with gang is not recommended as the answer to this problem - as men, especially, may be reluctant to use a facility with a reputation for women, families and the transgender community.      

    The Single-Occupancy Advantage

    • Helps millions with shy bladder syndrome;
    • Helps opposite-sex parents and caregivers waiting outside of gang restrooms or bathing rooms creating safer environments;
    • Helps transgender restroom and bathing room issues including state bathroom laws;
    • Reduces waiting lines for everyone known as gender or potty parity.

    Single occupancies often reduce building square footage and energy usage (see attached drawing and cost differential files).  Figure around a 6% added cost multiplier over gang per the attached clustered single-occupancy design, having the smallest rooms, and utilizing an egress instead of a dedicated corridor. 

    If the total new building size is reduced by the saved square footage, energy savings can pay this back. 


    In 2010, The National Organization For Women (NOW) provided testimony to the Committee on Oversight and Government Reform - In Support of H.R. 4869, The Bipartisan Restroom Gender Parity in Federal Building Act.  For sanitation issues, NOW simply requests toilet seat covers and soap be maintained in the dispensers in gender-neutral, single-occupancy toilet rooms.

    Spring lifting toilet seats could be considered instead in the non-accessible rooms yet not in accessible per 2010 ADA 604.4.   


    Multiple occupancy facilities have been designed since ancient Rome yet can now become obsolete.  Yet then, they should have never been designed in the first place, nor should they ever be designed again.

    Bruce Pitts
    A&E HVAC Mechanical Engineering
    Aiken SC
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