Most public health scholars might spend their summers in the laboratory, but Yale School of Public Health student Antonia Caba SPH ’20 spent hers at an architecture firm.

Instead of designing experiments, Caba was designing recommendations for all-gender, all-inclusive restroom prototypes.

Caba, who is studying social and behavioral sciences, worked with Yale School of Architecture adjunct professor Joel Sanders on his “Stalled!” project. Stalled! was formed in 2015 in response to the public debate surrounding transgender individuals’ access to public restrooms. For the project, Sanders and his team designed an all-inclusive restroom prototype that accommodates the trans community and aims to be accessible to all individuals, regardless of gender, age, race and religion. Caba was brought onto the team as a summer intern to examine bathroom preferences and experiences from a public health perspective.

“Access to bathrooms is inextricably tied to our health,” Caba said. “The fact of the matter is, we all ‘eliminate’— to put it more prettily packaged — so we need access to bathrooms where we can do that safely, comfortably and privately.”

According to Sanders, the all-inclusive restroom prototype envisioned in Stalled! includes communal washing and grooming stations as well as increased acoustic privacy. In an interview with the News, Sanders noted that these inclusive prototypes “eliminate the binary” and treat the bathroom as a “porous extension of public space.”

“We’ve also expanded the purview of the restroom to begin to accommodate what our research shows are the many different activities that take place in bathrooms,” Sanders said. Such activities, for example, might include prayer and breastfeeding.

Along with Sanders, the Stalled! project involves a variety of people with unique perspectives, including transgender historian Susan Stryker and legal scholar Terry Kogan. But Sanders noted that people who had seen the prototypes were interested in seeing “more end user data” and learning more about people’s “lived experiences.” As an architect, he said, conducting surveys and collecting data were outside the scope of his expertise. He wanted to collect more data from a “wellness perspective.”

Sanders discussed his desire to incorporate a public health perspective with Yale School of Public Health associate professor John Pachankis, who recommended Caba for the job. In an interview with the News, Pachankis noted that trans individuals may experience “stress” or concerns for “safety” with traditional sex-segregated restrooms, and the Stalled! all-inclusive bathroom prototype might help alleviate such concerns.

Caba’s work over the summer was an extension of work she carried out in School of Public Health assistant professor Danya Keene’s class. For the class project, Caba conducted interviews and examined the experiences of trans and non-binary students using different kinds of bathrooms on campus, their perceptions of the inclusivity of campus bathrooms and in which restrooms they felt most comfortable.

“One of the most illuminating findings was that many of the people we interviewed were expending significant mental energy trying to decide where to use the bathroom,” she said.

She took the project further over the summer by conducting additional interviews and surveying over 100 cisgender and gender-diverse students from Yale and other universities; Caba wanted to gauge their preferences for and experiences with three different bathroom types: single-user, multi-user sex-segregated and multi-user all-gender. She also conducted a literature review, she noted, to help “build this argument that bathroom design shapes health and well-being of diverse populations, not just trans and non-binary students.”

“I found that there are diverse populations that experience access issues in regards to bathrooms as well as design considerations that impact a lot of different populations,” Caba said.

For example, she noted that people who use men’s bathrooms and menstruate do not have access to receptacles for menstrual waste products. As a result, they will have to take those waste products into a public space, which might make them feel uncomfortable or perhaps put them at risk for violence. Furthermore, she noted that many people use bathrooms as a space for respite. If someone has anxiety or sensory challenges or simply needs a place to take a breather, she said, the bathroom can be a space used to rest and to “take a time out.”

Moreover, preliminary findings from Caba’s survey indicate that students from her study population are “overwhelmingly” supportive of all-gender bathrooms. She will analyze and further explore the data she collected over the summer for her masters thesis.

Caba is hopeful that her findings will help inform design considerations in further prototypes for Stalled! For instance, Caba mentioned the possibility of incorporating a wellness room where people can rest or mothers can breastfeed — a space that could be used by multiple people with diverse needs.

As for the future, she and Sanders hope to continue their collaboration. Sanders, who found Caba’s work to be “spectacular,” noted that their collaboration has convinced him that there is a “future” in joining forces between two fields and departments that typically rarely talk to one another. Sanders and Caba have even discussed collaborating on a book chapter together which incorporates Caba’s findings from the summer.

“The public health world can bring a lot to the design world and likewise the design world can bring a lot to public health,” Caba said.

Work from Sanders’ architecture firm can be found in collections at the MoMA, among others.

Taylor Eisenstein |