Just Read: “Universal Design” – Focus on Building Inclusive Bathrooms In the First Place

They fixed them, sort of. But not really. #safebathroomsDC GiantFood #shaw DCHumanRights
Bathrooms, built circa 2013. Then they fixed them, sort of, circa 2015, but not really. I’d still call them unsafe. Could have designed them right the first time. #safebathroomsDC @GiantFood #shaw @DCHumanRights (View on Flickr.com)

The architects (@AIAnational) just taught me the coolest concept when we got together recently. (see: Bleeding to Leading – Design and Health at the American Institute of Architects).

“Universal Design” caused the skies to part and the sun to shine through into my double rainbow atmosphere.

Why? Because it’s a known practice in design for creating respectful, accessible environments, including for the LGBTQ community, including bathrooms.

I’ve written a bunch about safe bathrooms here, in concert with the work we did at Kaiser Permanente to understand the transgender person health experience (KP Lantern), and in general.

I had no idea this concept existed until it was mentioned to me. This is why I love collaborating with professions other than my own.

Universal Design was initially defined as producing buildings and environments that are accessible to people with different physical abilities but it has since been broadened:

Universal Design (UD) is an approach to design that increases the potential for developing a better quality of life for a wide range of individuals. It is a design process that enables and empowers a diverse population by improving human performance, health and wellness, and social participation (Steinfeld and Maisel, 2012). It creates products, systems, and environments to be as usable as possible by as many people as possible regardless of age, ability or situation. Other terms for Universal Design used around the world include Design for All, Inclusive Design, and Barrier-Free Design.

So it’s actually a thing (See: An Introduction to Universal Design | Dwell) in the architecture world that can be leveraged to produce safer spaces for all, including safer bathrooms.

Surprisingly, on my search, I found very little related to Universal Design and LGBTQ people, except for a few blog posts and this excellent paper:

Daniels JR, Geiger TJ. Universal Design and LGBTQ (Lesbian, Gay, Transgender, Bisexual, and Queer) Issues: Creating Equal Access and Opportunities for Success. Online Submiss. 2010. [Accessed March 14, 2016].

Universal Design applies to LGBTQ People, too

In the paper, geared toward education, the authors made the connection that I made instantly:

Universal design is a philosophy that, when applied to higher education, constitutes acceptance of, equal access for, and equal opportunities for success for all students. The basic tenets of UD were originally developed to address the challenges of designing a campus for students with physical barriers, however recent theorizing has expanded the basic tenets of UD to encompass the needs of students with disabilities and disadvantages that are not necessarily visible (Burgstahler & Cory, 2008), such as LGBTQ students.

The currency of opportunity is time

The authors also made the same connection I have made for our patients for many years now – that the currency is time, not money. They speak of “time disadvantage” which is about

spend(ing) additional personal time and psychological energy to actively engage the learning system in challenging the existing pedagogical barriers, such as negotiating with support staff and attending to the completion of accommodations in the classroom or other campus setting

This is exactly what our patients face in trying to achieve their life goals through optimal health when unnecessary hurdles are erected in their way. I wrote about this previously on this blog (see: When measuring costs in health care, value patient time the highest).

I am in complete agreement, and again, happy that what I’ve always thought is validated by researchers in another profession.

Universal Design Principles and Gender Neutral Bathrooms – Proactive not Reactive

The Universal Design model has 6 principles, that when applied to the experience of LGBTQ people, includes safe bathrooms in 3 of the 6. Adequate bathroom facilities are that important to participating in any endeavor in society.

The importance of this well-described concept in architecture to the health and well being of the people we serve is the fact that it’s proactive rather than reactive:

Universal design is also a particularly useful framework for this discussion because it applies a proactive approach to solving LGBTQ-related concerns in a way that will prepare a classroom for a potential student, rather than reacting to a particular student in a particular course, major, or semester with a problem.

The reality is that there’s no evidence that gender segregated bathrooms are any safer than gender neutral ones. In fact the opposite may be true. In reality, the current non-universal model in many places uses a person’s sex to divide and reduce opportunities to all students/people/humans, not just people who are LGBTQ.

Universal Design benefits everyone

Fortunately, colleges and other institutions are recognizing that it’s much healthier to focus on designing for everyone rather than designing for some and then focus on others. For example: New gender inclusive design standards to guide future bathroom, locker room labeling — The Bowdoin Orient.

The same is happening in health care, hospitality, and in many large organizations.

Being LGBTQ Does not Constitute a Disability

The authors make this clear:

Because of the reliance of universal design for a framework, it is important to clarify and emphasize that being an LGBTQ student does not constitute a disability in the literal sense that universal design was based on, which was “the design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation of specialized design” (The Center for Universal Design, 1997a, p. 1, as cited in Burgstahler & Cory, 2008).

Any disability or time disadvantage that LGBTQ people face are potential ones created by the world around them, and are completely unnecessary. In fact, it’s probably more costly to design and behave in a non-universal way than it is to be universal.

It’s all about characterization

I love this quote

A useful device or facility can have different fates depending on how it’s characterized. Fletcher told me about Ron Mace, an architect and polio survivor who’s often credited with first deploying the term “universal design.” Mace liked to invoke electronic garage-door openers as an example: Suppose they had first been developed as assistive technology — that is, for use by people with disabilities who couldn’t manually lift a garage door. First of all, Mace suggested, they’d have cost $800 apiece. Second, no one would have used them but those with disabilities — the use of the device would have labeled a person as disabled. Instead, a tool developed for no one in particular is used by everybody. Fletcher asked me to remember the last time I’d lifted a suitcase and carried it by its handle: wheeled suitcases and curb cuts mean that people of different abilities can all benefit. Though the early adopters of self-driving cars might well be blind and visually impaired people, they will soon be followed by the rest of us.

[Easy Chair] | Universal Use, by John Crowley | Harper’s Magazine

About using our minds rather than our money

One day this will be the norm. Until then we simulate the future to respect the #LGBTQ people we serve #safebathroomsdc
One day this will be the norm. Until then we simulate the future to respect the #LGBTQ people we serve #safebathroomsdc (View on Flickr.com)

So in the end, supporting safe and productive spaces for all people has less to do with retrofitting our buildings and more to do with retrofitting our brains.

In addition to “Universal Design” we now have the WELL Building Standard, which supports the health and well being of the people in buildings. WELL doesn’t yet include gender neutral bathrooms, but it should (and I predict it will). (see: Just Read: The WELL Building Standard – promoting health for the people inside)

When facilities are designed for all to begin with, arguments about who should use which bathroom will be irrelevant, public facilities will be used by the public, with safety, health, and equal opportunity. All of the crazy workarounds and hand written signs will be gone – everyone will be time ADvantaged instead of time DISadvantaged.

The 21st Century is fantastic, architects are as responsible for health as doctors are, and I plan to use the term “universal” a lot more now.

To see an example of what well designed public facilities look like, check out Innovation, Respect, Safety, Beauty: Multistall gender neutral bathrooms at The Coupe DC.

Gender Neutral Multistall Bathroom DC 55195
Gender Neutral Multistall Bathroom DC 55195 (View on Flickr.com)

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