| Objective: To understand the current situation of transgender people’s toilets and their demand for gender-free toilets in China,and to provide theoretical basis and data support for urban planning and management departments to install more gender-free toilets,in order to increase the visibility of sexual minority issues and improve the survival quality of LGBT.Methods: Transgender people in China were surveyed using a self-designed questionnaire to investigate their basic information,psychological pressure when using bathrooms in public places,bathroom experiences,and their views and attitudes toward different bathrooms.The questionnaire was filled out voluntarily and anonymously using a web-based questionnaire with an informed consent form at the beginning of the questionnaire,and the questionnaire filler could withdraw from the study at any time for any reason by refusing to fill it out.The data were statistically analyzed using nonparametric tests,correlation tests,and ordered multicategorical logistic regression.Result: The pre-survey results showed good reliability and validity of the questionnaires(Cronbach’s α values were higher than 0.70,KMO values were higher than 0.60,and Bartlett’s spherical test P values were less than 0.001).A total of 1299 questionnaires were collected in the formal survey,and 1008 valid questionnaires were obtained after excluding invalid questionnaires,with a valid recovery rate of 77.60%,including 267(26.49%)transgender males,531(52.68%)transgender females,and 210(20.83%)gender-cool children.1.The results of the survey on the psychological stress of transgender people using toilets show that: transgender people who choose female toilets,the proportion of moderate and above psychological stress is65.56%,62.59%,44.07% and 19.63% before entering,when using the toilet,after leaving and if using genderless toilets respectively;transgender people who choose male toilets,before entering,if using urinals,if using squatting toilets after leaving,and if using a genderless bathroom,the percentages of moderate and above psychological stress were 69.38%,87.57%,40.98%,50.74%,and19.67%,respectively.The results of the two-by-two comparison showed that the distribution of stress scores if using genderless restrooms differed from all other situations(P < 0.001),and the difference between urinal and squatting situations was also statistically significant(P < 0.001).2.The results of the survey on experiences related to public restrooms showed that:unpleasant experiences in the restroom were dominated by self-psychological discomfort(63.19%)and being watched by strange eyes(56.75%);events experienced due to refusal to use public restrooms were dominated by holding urine(77.38%)and avoiding eating and drinking outside(64.38%);fear of using public restrooms was dominated by fear of being watched,ridiculed,insulted,or violated(P < 0.001).fear of being watched,ridiculed,insulted or violated(75.50%)and fear of moral condemnation(57.94%).3.The results of the survey on the views and attitudes toward different types of restrooms show that 80.06% of transgender people show resistance to regular public restrooms,73.02% support genderless restrooms,and 82.64% expect to have more genderless restrooms.Only 30.16% have seen genderless bathrooms in public places they frequent,and only 9.41% of transgender people(65.38%)who have actually used a genderless bathroom feel uncomfortable.4.The results of correlation analysis and multivariate analysis showed that there was a correlation between the psychological stress of toilet use in transgender people,unpleasant experience in the bathroom,the events experienced due to refusal to use the public toilet,the reasons for fear of using the public toilet,and the perception and attitude towards different toilets(P<0.001),and the results of ordered multiclassification logistics regression analysis showed that heterogeneous gaze(OR=2.31,95% CI: 1.73-3.09)and self-psychological discomfort(OR= 2.48,95% CI: 1.88-3.26),holding urine(OR=1.97,95% CI: 1.41-2.75),peeing pants(OR=1.50,95%CI: 1.09-2.06),avoiding eating and drinking outside(OR=1.40,95%CI: 1.03-1.90),ending the current activity early(OR=1.72,95% CI: 1.27-2.32),worrying about moral condemnation(OR=1.87,95% CI:1.46-2.39),fear of being gazed,ridiculed,insulted,or violated(OR=1.62,95% CI: 1.21-2.18)may affect the level of toilet stress in transgender people.Conclusion: 1.Transgender people who participated in the study felt more psychological stress than using a regular restroom than using a genderless restroom.2.Most transgender people have unpleasant bathroom experiences when using public restrooms,experience events that affect normal activities and travel when refusing to use public restrooms,and are afraid of using public restrooms because they fear being treated unfairly.3.Compared with ordinary public restrooms,genderless restrooms can better meet the needs of transgender groups in terms of toileting.4.Transgender people who experienced strange gaze,self-psychological discomfort,holding urine,peeing their pants,avoiding eating or drinking outside,ending the current activity early,or fear of being watched,ridiculed,insulted or violated,or fearing moral condemnation had higher toilet stress levels,and the need for genderless restrooms increased with the toilet stress score. |
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