Urine-Nation: Private body functions in Private Spaces

There is no bodily need more universal than when you gotta go, you gotta go. Public restrooms are an essential piece of public health and sanitation, worker productivity, and customer service (7). If you want people to be economically productive and spend time extended time in commercial centers, there has to be a way for people to use the restroom. And yet, the truly public restroom is a rarity in US cities. Public restrooms have always been politically charged spaces. Architectural historian Barbara Penner noted,

“Unless we recognize the part that bathrooms play in enforcing order and existing power relations, it is hard to make sense of why they are often such bitterly contested spaces” (8).

Examining the legacy of public restrooms provides an important lens for understanding inequality and shaping future interventions in public space. Norms in bathroom design and availability define what are considered normal body functions and who might be included in a productive society. Bodies have to urinate, defecate, and menstruate, so restricting where, how, and with whom those acts take place is a powerful tool in enforcing social order.

Historically, the absence of public bathrooms for people of color, women, and people with disabilities created a pee leash, a barrier for how far or long a person could stray from home without risking embarrassment (9). As phrased by menstrual hygiene technology historian Sharra Vostral, “In a society that values cleanliness, stained clothing can be read as a moral, and not a technological, failure” (2). With the stakes for hygiene so high, bathrooms define who has access to public space. In the history of design for public urination, municipalities have disproportionately focused on design for men over women. The reasons are numerous, including women’s lack of influence over public works, the invisibility of domestic labor, cumbersome clothing, and the male anatomical advantage of aiming. But deeper cultural attitudes at the intersection of gender and class, which still persist today, also explain the spatial organization of public restrooms.

In availability and use, female facilities reflect women’s historically limited agency in public space (9). Gendered differences in how we relieve ourselves only exist in public space. Many of these norms were established during the Victorian era, when the belief in privacy, modesty, and “separate spheres” for men and women was met with anxiety over rapid changes in labor and technology. 5 As urban populations swelled and knowledge of germ theory advanced, cleanliness became a new morality. Poor personal hygiene and sanitation put society at risk for infection and contagion (10). “Cleaning up the streets” was not a euphemism for moral policing, it was one and the same.

Designed to mimic the act of peeing on the street, the urinal emerged in the 19th century as the hygienic crisis of human waste (11). Pissoirs, an outdoor urinal with a privacy enclosure, began to emerge throughout Western Europe. While the streets were previously soiled by men and women equally, germ theory turned public urination into a taboo and the urinal as a hygiene solution defined public space as male (12). It enabled men to relieve themselves in public without stigma, but restricted it for women. Efforts to design female public restrooms were actively protested by both men and women (12) under the guise that allowing women into the public realm would “endanger both women’s weaker bodies and the welfare of future generations” (5) As women entered the industrial workforce, anxieties over their protection was met with the demand for productivity.

Gender segregated public restrooms first emerged in Industrial Era factories that employed large numbers of women. Separate restrooms were already common outside the home during this time period, but the practice was not enforced by law in the U.S. until 1887. In an essay on Victorian restrooms, Terry Kogan argues that “policy makers were motivated to enact toilet separation laws aimed at factories as a result of deep social anxieties over women leaving their homes to enter the workforce” (5). Women received more legal protection than men over factory sanitation standards. Believing that women’s emotional and physical weakness required space for modesty and retreat, factories employing large numbers of women were required to create separate women’s bathrooms that included private stalls and areas for rest. The origins of this design norms are obviously problematic, but have set a precedent for women’s restrooms as places for bodily care. Contrastingly, male factory workers received minimal sanitation standards and acknowledgment of their physical needs. At this time, the urinal also moved from the streets to the factory floor, since it enabled shorter bathroom breaks and therefore a more productive workforce (11). They were successful from an efficiency standpoint, but remain a unique breed of anti-social object within the confines of an indoor male restroom.

Moving forward a few decades to the post-WWII office environment, ratios of male to female restrooms and the presence of urinals became symbolic of male privilege and female exclusion (9). Designers have experimented with female urinals, but variation in women’s clothing and their difficulty of use have prevented their rise. Decades of legislation has attempted to reflect gender relations in public space, but it is always the site of contention (8). Broadly, Americans did not agree on male/female bathroom standards until the passage of the Equal Rights Amendment in 1972 (2), which introduced regulations on the design and presence female bathrooms in public spaces and professional settings. A key bargaining chip between proponents and opponents of the ERA was the continued separation of male and female bathrooms, as opposed to unisex. Somewhat ironically, the absence of urinals legally defined bathrooms as female, rather than the introduction of any design for female bodily needs. Bathrooms were defined as female through absence of design. The more our society designs for female bodies, the more valued women’s contributions become.

Moving outside the gendering of workplace bathrooms, building highly visible bathrooms never received the same attention in the US as in major European cities. Many cite puritanical views on bodily privacy for both genders as the main reason, but the rise and fall of the Comfort Station movement reveals how it was also about moral policing and economic privilege. In his essay, “Restrooms in American Cities, 1869-1932,” Peter Baldwin describes the 19th century progressive movement to build underground public restroom facilities, euphemistically called comfort stations (14). This movement reflected the progressive struggle to subject the private body to public stewardship and was largely championed by female activists of the day. It was equally motivated by concerns about sanitation and personal morality. The sanitation argument was familiar, but this moral framing was new. At the time, public restrooms were only available only in customer serving establishments, like restaurants, department stores, and bars. Female leaders of the temperance movement thought men were being innocently lured into bars and brothels by their bladders, then compelled to drink in exchange for using the bathroom. Public restrooms unaffiliated with debauchery, comfort stations were promoted as the moral alternative.

Female facilities were included in most comfort stations, but the primary purpose of the female section was to compel men to behave better due to their presence. Despite the novelty of a public women’s restroom, they were rarely used. This was due to class tensions. Women’s sense of privacy did not extend to a culturally and economically mixed setting. Wealthy women preferred to use the restrooms of private establishments like department stores in exchange for their patronage. Poor men benefited from all men’s need for urinals. But without wealthy and middle class women making a similar demand of public space, poor women’s needs were doubly not considered. The class conflict behind comfort stations was clear, as one station was torn down for being “in too public a place.” Calls for comfort stations died with prohibition, as moral progressives no longer needed an alternative to the saloon bathroom as a deterrent for drinking.

In America today, the truly public restroom is a rare sighting – male or female (7). Small businesses and coffee shops have become the band-aid solution, with some acknowledging their role more directly. In response to the public relations crisis surrounding a manager who called the police on two black men who asked to use the restroom without proof of purchase, Starbucks has announced that they will allow anyone to use their restrooms. CEO Howard Schulz said at the Atlantic Council in Washington D.C.,

“We don’t want to become a public bathroom, but we’re going to make the right decision 100 percent of the time and give people the key. Because we don’t want anyone at Starbucks to feel as if we are not giving access to you to the bathroom because you are ‘less than.’ We want you to be ‘more than.’”(14)

It’s not reasonable to expect every coffee shop in America to offer public restroom usage without compensation for staff and maintenance costs, but this statement is an important move forward. It acknowledges that public restrooms aren’t purely about hygiene and productivity anymore; they’re about expressing care and an acknowledging bodily needs as human needs.

Examining the legacy of public restrooms is important as society confronts their role in enforcing gender, class, and race. Debates on how and with whom we share public restrooms are fueled by larger issues around social identity (15). People in power rely on our inescapable need to relieve ourselves and the intertwining issues of hygiene and morality as leverage to enforce social order. These forces are still at work today as trans-discriminatory bathroom policies are being used to legislate cisgender identity (7). Making public spaces accessible to all requires design attention to those who have historically been neglected or deliberately excluded. The lack of design consideration for menstruation reinforces it, and menstruating bodies as abnormal. The lack of truly public restrooms in America reinforce hygiene as a privilege only for consumers and those who can pass as one. Public restrooms are an important way for cities to express care and expand who belongs to the commons.


  1. 7. Molotch, Harvey Luskin, and Laura Norén. Toilet: Public Restrooms and the Politics of Sharing. New York: New York University Press, 2010.

  2. 8. Anthony, Kathryn H. Defined by design: the surprising power of hidden gender, age, and body bias in everyday products and places. Amherst, NY: Prometheus Books, 2017.

  3. 9. Banks, Taunya Lovell. “Toilets as a Feminist Issue: A True Story.” Berkeley Journal of Gender, Law, & Justice. 2013; 6(2): 263- 289.

  4. 10. Farmer, Paul. Pathologies of Power: Health, Human Rights, and the New War on the Poor: With a New Preface by the Author. Berkeley: University of California Press, 2004.

  5. 11. Howe, Andrew. “The Urinal: A Brief Functional and Aesthetic History.” PopMatters. February 01, 2011. Accessed November 28, 2017. https://www.popmatters.com/126662-the-urinal-a-brief-functional-and-aesthetichistory-2496183047.html.

  6. 12. Penner, B. “A World of Unmentionable Suffering: Womens Public Conveniences in Victorian London.” Journal of Design History 14, no. 1 (2001): 35-51. doi:10.1093/jdh/14.1.35.

  7. 13. Baldwin, Peter C. “Public Privacy: Restrooms in American Cities, 1869-1932.” Journal of Social History. 2014; 48(2): 264-88.

  8. 14. Doubek, James. “Starbucks: No Purchase Needed To Use The Restroom.” NPR. May 11, 2018. Accessed May 19, 2018. https://www.npr.org/sections/thetwo-way/2018/05/11/610337214/starbucks-will-give-people-thekey-to-restroom-regardless-of-purchase-ceo-says.

  9. 15. Armborst, Tobias. The Arsenal of Exclusion/Inclusion 101 Things That Open and Close the City. New York: Actar Coac Assn of Catalan Arc, 2017.

  10. 16. Pokharel, Sugam. “Nepali ‘menstruation Hut’ Ritual Claims Life of Teenage Girl.” CNN. July 12, 2017. Accessed May 19, 2018. https://www.cnn.com/2017/07/10/asia/nepal-menstruation-hut-deaths-outrage/index. html.

  11. 17. Gharib, Malaka. “Why 2015 Was The Year Of The Period, And We Don’t Mean Punctuation.” NPR. December 31, 2015. Accessed May 19, 2018. https://www.npr.org/sections/health-shots/2015/12/31/460726461/why2015-was-the-year-of-the-period-and-we-dont-mean-punctuation.

  12. 18. Respondents were recruited via snowball and convenience sampling through online social networks. A limitation to this data is that all respondents were cisgender women with at least some college education. A more economically diverse sampling, including trans men would yield different results.

  13. 19. Bobel, Chris. “Menstrual Pads Can’t Fix Prejudice.” New York Times, March 31, 2018. Accessed May 21, 2018. https://www.nytimes.com/2018/03/31/opinion/sunday/menstrual-periods-prejudice.html. 20. Fitzpatrick, Kevin, and Mark LaGory. Unhealthy Cities Poverty, Race, and Place in America. Florence: Taylor and Francis, 2013. 21. Fitzpatrick, Kevin M. Pov

Done? Done! Done... 1 year later!

One of the first questions that comes up during cancer diagnosis is “when will I be DONE?” The fantasy of my post-treatment life was the fuel that got me through the tough moments, so I had a lot of emotional attachment to calendar milestones. The most devastating moment of treatment for me was over a 1 week delay; my WBC count was too low for chemo one week so everything got pushed back. I wasn’t upset that I was sick; I was upset that I’d have to adjust my projected timeline. After a comfort rewatch of some GOT with my Dad, I cried into my keyboard updating my treatment database with a new “done date”.

But here’s the challenging bit. It’s hard to know when you’re “officially done” with cancer treatment. There are so many starting and stopping points through the different phases of treatment. Then even when you’re done, not only do you look and feel like a naked mole rat, you’re still going to be monitored, for years. Done is a state of mind and not all cancer patients get to hang their hat on that term. I was very fortunate that my treatment was curative and I got to fantasize about normal+ life.

I choose to celebrate TODAY, November 9 as DONE. On this day last year I got my last radiation treatment and rang that big ass gong. There were some other treatment bits after that, but this was the last thing that caused me uncomfortable side effects. After this day, I could just focus on regaining health and start filling the the enormous space in my life that was being a patient with all the things that make me happy.

But since Nov 9 is a somewhat arbitrary choice, here is a non-exhaustive list of some of the milestones I celebrated over the course of treatment and recovery (vaguely in chronological order)..,

  1. Finishing egg freezing IVF with only 1 emotional breakdown over insurance issues and 1 embarrassing incident when I did a monologue on Henry Winkler while coming out of sedation!

  2. Getting through my first chemo treatment with none of the worst case scenario side effects!

  3. The first chemo appointment my team didn’t have to give me IV Benadryl as a precaution!

  4. The first appointment with no major nausea because I finally figured out the diet/OTC drug ritual!

  5. My last day of the first chemo regimen!

  6. My last day of any chemo!

  7. My last bone marrow stimulant treatment!

  8. The last time I cried during an insurance conversation saying “I know this isn’t your fault, but this is harder than the cancer.” (pro tip: don’t switch jobs in the middle of cancer treatment)

  9. Reintroducing hot sauce into my diet!

  10. My first NED (no evidence of disease) scan post chemo!

  11. My first post-treatment spicy marg!

  12. Getting through surgery!

  13. My first day going out in public without my wig!

  14. My last day of radiation! (November 9!)

  15. The first time I ran more than 2 miles since starting treatment!

  16. The day I won the “who can hit their out of pocket max first” contest among my cancer community with 1 keytruda infusion on Jan 3 ($35K a pop)!

  17. My last immunotherapy treatment and last infusion of any kind!

  18. Full eye lashes!

  19. The last day I neded to fill in my eyebrows to have facial expressions!

  20. Getting my port removed!

  21. First time finishing a 1 hr yoga class with no pain around my surgical site!

  22. The first time I didn’t need a notetaker with me during a doctor appointment to help with brain fog!

  23. My first 5K race again!

  24. The day I woke up with clarity that “oh, hell yeah my hormones are back to normal!”

  25. The first time I ate Chipotle again!

  26. The first month with no doctors appointments or medical leave from work!

  27. 1 year post-chemo! (margs)

  28. The first day my hair looked like a hair cut I would have chosen!

  29. 1 year post surgery!

  30. My first ponytail!

  31. 1 year post-radiation! (today <3)

  32. … more to come!

I did a podcast!

I had the honor of being invited to speak on communication best practices in healthcare user experience research. Give it a listen!

Some of my favorite communication best practices:

  • When it comes to complex subject material, it always helps that I’m never the expert. As a designer, I’m always brought in to be the outsider/novice. So I’m not emotionally attached to previous ways of communicating something and can trust my ability to pick out key insights from the noise. My goal is always to make something that feels simple that’s still an honest reflection of the true complexity.

    • As a researcher, keeper of the data and the stories, it can be so difficult to edit out quotes or analyses that detract from your call to action. But just because you know it, doesn’t mean you need to show it. So you need to be a ruthless editor.  

    • To co-opt the Teddy Roosevelt truism, “Speak softly – and carry a big appendix.” If something feels extraneous, but I think it could come up in questions or be useful down the line, I create extra slides, or make my raw data/analysis accessible so that those who want to go down rabbit holes have every opportunity to without interfering.

  • Understand what type of appeal you’re making and be careful not to try to boil the ocean. I like to break down intent by “Head, heart, and hand.”

    • Head – Is this about a gap in knowledge or understanding?

    • Heart – Is this about aligning on emotions or motivations?

    • Hand ­– Do we not know how to act on what we know and feel?

  • Listening can be such an undervalued aspect of communication. I’m disciplined in listening with intent to understand, not to respond. In my first year working in healthcare tech, the imposter syndrome was overwhelming. I was the least academically credentialed person in every room I was in and I was defensive – I asked questions to show them I know what I’m talking about. And that is a horrible way to connect and learn from people. If you can let go of your ego a little bit, people can be surprisingly gracious teachers.

  • Create space for people to ask “dumb questions” and model this behavior when others are presenting to you. Give people pause and permission to say when something isn’t clicking and be prepared with a fat appendix of alternatives. We have all been stuck in presentations where something technical goes over our head and then we kind of give up and check out. We blame ourselves instead of blaming poor communication. There’s power in confidently acknowledging what you don’t know. And experts love being asked questions; they want nothing more than to clear up that confusing bit from a few slides back.

Enjoying the Fruitcakes of Labor

Mid-December update from my baking corner, with a short love letter to a much maligned midwinter treat: the fruitcake.

The past few years I’ve been refining a fruitcake recipe on my Dad’s request. It was a favorite of his and he had a hard time finding a store bought one that met his flavor preferences. Luckily, this is my ideal challenge. I started with a NYT recipe and then gradually adapted it. I make it very cherry-forward and soaked in ample Whiskey - kind of like a Manhattan in a loaf pan.

As making this has become an annual tradition, I’ve found poeticism in fruitcake’s most suspicious quality: it’s shelf stability. Traditionally, fruitcake was made from the dried remnants of that year’s fruit harvest. It would sit on a shelf for a full year until it was ready to be enjoyed as the next year is about to begin. It’s still good if you eat it right away, but the flavors get so much richer if you give it time. You can enjoy previous year’s fruit, in its present form of fruitcake, while preparing to enjoy this cycle in the next year.

It’s shelf-stable time travel.

This symbolism is hitting harder this year because it’s been a banner year for challenging new experiences. Let the record show that while I don’t recommend switching jobs, buying a home, ending a relationship, and being diagnosed with cancer all in one week, it was survivable. But that was it, it was just survivable. So much labor went into this year, but that labor was spent on survival.

In December 2023, my cancer experience will be a full year behind me. It will not only feel more distant, but I’ll have had an entire year to take what I’ve learned from this fairly traumatic 2022 and channel it into something complex and wonderful.

It’s gonna be a great fruitcake.



Dad’s Nutty Bourbon Fruitcake

Ingredients

  • 6.5 c. assorted dried fruit (lots of cherries, prunes, and apricots)

  • 1 c. bourbon

  • 5.5 c. mixed nuts (walnuts, pe- cans, brazil nuts, and cashews)

  • 1.5 c. AP flour

  • 1 t. baking powder

  • 1 t. salt

  • 6 eggs

  • 1 c. sugar

  • 2 t. vanilla

  • 1⁄2 t. salt

  • 3⁄4 c. bourbon

Instructions

  1. Prepare fruit mixure 1–2 days in advance. Chop fruit evenly and soak in 1 c. bourbon. Cover and store in a cool, dry place. Stir occasionally.

  2. Preheat oven to 300°. Grease and line a 9x5x3 loaf pan.

  3. Chop nuts and combine with fruit mix.

  4. Sift flour, baking powder and salt over nuts and fruits. Toss lightly until well coated.

  5. Beat eggs, sugar and vanilla until fluffy and light. Pour over nut mixture. Stir gently to combine.

  6. Fill prepared loaf pan, pressing cake mixture firmly so it fills the pan evenly.

  7. Bake for 90-105 min or until a toothpick comes out from the center clean (1 hr for a mini loaf pan).

  8. After removing from oven, brush 1⁄4 c. bourbon over cake. Let stand one hour. Invert and cool completely on wire rack. Soak with remaining 1⁄2 c. bourbon.

  9. To store: Wrap in cheesecloth that has been soaked in bourbon. Wrap in heavy duty foil or store in tightly covered container. If cheesecloth dries out, dip in bourbon and rewrap cake.

Serving Suggestion

It is shelf-stable for up to a year, but I like keeping mine in the freezer. I like to serve mine lightly toasted with apricot jam!

It's nice to be petty: Body Image After Cancer

I want to begin by acknowledging my thin privilege. While I’ve never considered myself skinny, maintaining a doctor approved BMI has never been a struggle. I typically hover between 10-15 lbs over my ideal weight because (in stark contrast with the Kate Moss tagline) I think there are about 1 million things that taste better than being skinny feels. I genuinely love salad and other traditionally healthy foods, but also I love decadent meals and dessert enthusiasm is not an insignificant part of my personality. I will go through periods of regular exercise, when I’m feeling particularly into a gym class or motivated by a distance running goal, but I workout so I can eat what I want and stay active/capable late in life. I don’t love working out.

So that’s my behavioral baseline. And then I started cancer treatment.

So many things have happened this year that make me feel like I’m not in control of my body. Cancer is a weird violation of self-love and body acceptance because the “bad cancer cells” are still part of your body. It’s quite literally a cellular rebellion against the self. On top of that, I (fortunately) never had physical symptoms until my first suspicious mammogram, but that made starting treatment a head trip because I felt like my body was being upended for an imperceptible problem. Treatment felt like the cause, not the cure, of my problems. My hair, digestion/appetite, energy, mental acuity, etc. were all suddenly things I had no control over. I made my peace with so much of it during the thick of chemo, but now that things are ending and so much is returning to normal, I feel acutely aware of and fixated on the things that have not returned to normal. And my hyperfixation of the moment is my weight.

An incomplete list of things that affect weight during treatment:

  1. Everything makes you unfathomably tired: The biggest side effect during all treatment phases was fatigue. I was zapped and drained in every way and I just didn’t want to do anything except play Zelda BOTW while watching Netflix. People love to point out that exercising in this state will actually reduce your fatigue and share stories about people who trained for marathons during treatment, but OMG * dramatic eye roll * PLZ STOP. It’s hard to get out of a fatigue spiral. I went from half marathon capable to incapable of running basic errands in 2 months.

  2. Steroids: As part of each chemo infusion, I was given steroids to help my body offset the worst side effects in the 24-48 hours. This was amazing, but you know, steroids make your body retain calories like crazy.

  3. I could only eat carbs: Many people answer the question, “what should I eat during chemo?” with “whatever you can.” My appetite decreased dramatically, but the only foods I had any interest in eating were carbs and occasionally cheese. Bring on the bread and crackers. Peanut butter toast, mac&cheese, broth-based soups, greek yogurt, and occasionally grain salads were my go-to staples. For digestive reasons I DON’T WANT TO GET INTO, I couldn’t eat the salad greens, veggies, and fruit I normally rely on.

  4. Hormones and Menopause: My cancer experience began with fertility preservation. IVF hormones do a number of crazy things to your body, weight being only one of them. And then swinging in the opposite direction, chemo induces menopause. I am coming out of this now, but my hormones are all over the place. The hot flashes were the worst part of this for me, but it affects weight, mood, and a whole host of things in so many weird ways. If you know someone going through menopause right now, oh man, give them a hug and a cold compress. It sucks.

an icon to all us snackers

But now treatment is over. There is a type of cancer patient who goes a little orthorexic in response to cancer, who dives too deep into the "here’s how sugar feeds your cancer cells” type nutrition rabbit holes and focuses on eating “clean.” I am not that. Opposite.

I want to get back to my regular size and feel good about that, but but but also I missed my appetite soooo much and I just WANT TO EAT EVERYTHING. Cocktails, steak, various things deep fried and covered in spicy sauces and sugary glazes, enormous sandwiches, tacos, and pastry, so much pastry. My brain is just a looping video of Templeton the Rat’s Smorgasbord song from Charlotte’s Web. I want to give my appetite the time in the sun she deserves, but I also want to return to the body I had before the conga-line of medical care began.

And I know that, all things considered, I shouldn’t be hung up on what, in the grand scheme of things, is small number of pounds. This body got me through chemo, surgery, and radiation, shouldn’t I have emerged from this process with a new and profound sense of love and embrace of my body? But no, I have not. I’m cancer free, but I’m still a little bit petty.

In the continued theme of “cancer is not a lesson”, traumatic experiences don’t instantly turn us into zen masters. That’s the work that follows. My body still feels like an obstacle and for now I’m just going to sit with that discomfort as best as I can while I figure out a new relationship to health.