Most Schools Don't Have Clear Restroom Policies, and That's a Public-Health Problem

A new survey finds that just 8 percent of schools have concrete bathroom policies. That lackadaisical approach can have serious health consequences for students.
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Going more than three hours without a bathroom break can compromise bladder strength and cause future disorders.

For all the political debates raging around gendered bathrooms these last few years, the issue for many young people isn't a question of identity—it's access in the first place. A recent survey undertaken by the Society for Women's Health Research finds considerable evidence that students lack consistent and reliable access to their schools' restrooms.

Synthesizing data drawn from 362 nurses from elementary, middle, and high schools across the United States, the researchers found just 8 percent of schools had a concrete bathroom policy in place. Almost half the schools allowed free access to the bathroom (with students only having to ask as a formality). The rest reported restrictions being imposed on bathroom breaks during class. Holding in urine, it's long been documented, can have detrimental health consequences, including the spread of bacteria and weakened bladder muscles.

Mostly, restricted access seemed to be a matter of trust—or distrust. Eighty-four percent of the survey participants noted that teachers could not be sure students were using the restroom when they left class. Fifty-eight percent of the nurses believed that teachers denied students access to the bathroom during class because so much misbehavior occurs there. These fears are not necessarily unfounded: There is evidence, for example, that bathrooms are preferred sites of bullying at school.

Whether there's any deeper merit to these concerns (and assuming the nurses speak accurately for the teachers), the ensuing limitations pose a serious problem for student health, says SWHR's research director, Rebecca Nebel. "Restricting access to the bathroom," she writes in a summary of the report, "forces students into unhealthy toileting habits, such as holding in urine, which may create health problems that will follow students into adulthood and decrease their quality of life."

The nurses in the survey certainly agreed. With 75 percent of them reporting knowledge of students having bladder or bowel issues, and 20 percent (of all participants) claiming that they themselves lack adequate time to use the bathroom, it's no surprise that, at least from the perspective of the school nurse's office, there's a major time allotment problem at play.

As it now stands, students must often navigate confusing—and contradictory—school policies. There's an effort underway in many schools to encourage drinking lots of water as part of a larger push toward better personal health. But more water obviously means more frequent need to visit the bathroom. And as students aim for better living through hydration, they require better education about bladder health, and the danger of holding in urine. But only 2 percent of the schools mention bladder health education in their curricula, according to the SWHR report.

Bathroom measures, even for the 8 percent of schools that already have a policy in place, can actually incentivize unhealthy behavior. In one Austin, Texas, middle school (as reported by my daughter), sixth-grade students (at least in 2016) were given a set of bathroom passes (in some classes) to use throughout the semester. The passes that they did not use could be redeemed at the end of the semester for extra credit points. In other words, the students were rewarded academically for holding in their pee.

Such restrictions do nothing to explain why students have to frequently go to the bathroom during class in the first place. Usually, it's because they didn't have time to take care of business beforehand. Indeed, the ultimate culprit here is the limited time granted between classes—five minutes appears to be the norm, but some schools allow as little as three minutes. Student opinion appears to be universal on this point: They need more of it.

Over the last few years, some precocious middle school students have gone so far as to research the issue on their own campuses. According to one project, 82.5 percent of surveyed students were unable to use the time between classes to go to the restroom, get a drink of water, and make it to class on time. Students highlight the distances they have to travel, the fact that there's usually not a bathroom near the classroom, and crowded hallways. Another project, undertaken by sixth graders who were allotted only three minutes between classes, broke down the logistics of going from class to bathroom; their results—which showed that, for some students, it took 83 seconds to walk from the classroom to their locker, 35 seconds to switch books in their locker, and 25 seconds to find and use a water fountain—indicate how little time was left to attend the washroom (in some cases, less than a minute). In their survey, 85 percent of the students called for more time, if only a minute more.

It seems as if teachers and administrators generally think that a five-minute quota (or less) between classes is more than adequate to do all personal business. Only a third of the nurses surveyed thought students did not have enough time between classes to use the restroom.

In general, one does not find a lot of sympathy from teachers. A 2014 reader letter in Teen Ink captured what seems a likely response from many teachers who think students have plenty of time to use the restroom between classes: If I can do it, so can they. Per the (anonymous) writer:

My teacher has said a few times that during passing time, he can use the bathroom, go to the office to pick up his mail, fill up his coffee, and get back to the classroom just as the bell rings, so he doesn't think we need a longer passing time.

There's at least some good news in the report: Bathrooms were said to be overwhelmingly clean, free of offensive odors, and well supplied with toilet paper, paper towels, soap, and menstrual products. Still, one can't help but wonder if these hygienic conditions can be attributed to the fact that they're getting such infrequent use.

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