Having to "Hold It": Factors That Influence the Avoidance of Using Public Bathrooms among Transgender People.

Transgender people often avoid going to the bathroom in public, at work, and at school because they are afraid of facing problems while using them. Utilizing the 2015 U.S. Transgender Survey, the largest sample to date with transgender people, this study (N = 25,694) aimed to understand the factors associated with avoiding bathroom usage as well as how the avoidance may impact the health of transgender people. Logistic regression was used to examine factors associated with avoidance of bathrooms. More than six out of 10 transgender people avoided using public bathrooms. Being questioned about a person's bathroom choice, gender identity, perception of gender identity, previous experiences of discrimination, suicidal ideation, and serious psychological distress were found to be associated with avoidance of public bathrooms due to fears of having problems when using them. Gender-neutral bathrooms that are safe and accessible for transgender people need to be more available and accessible in the United States.