Franky Arambula knew the public restrooms on his daily delivery route by heart.
In suburban Mission Gorge, he delivered mail to single-family homes and exactly two apartment buildings. His route did not pass through any parks with public bathrooms or a business district with bathrooms open to uniformed postal workers.
Instead, one of the apartment buildings he delivered to had a communal bathroom in the pool area. Arambula used it daily, including during the pandemic when he was considered an essential worker.
Franky Arambula along his old delivery route in San Carlos. He transitioned while assigned to the suburban neighborhood. (Photo by Thomas Murphy/Times of San Diego)During the busy Christmas season in 2022, he tried the bathroom door to find it locked. Confused, he went to the apartment’s office. Arambula assumed maintenance had accidentally locked it. A receptionist told him it was now for residents only.
“She tells me, ‘I’ll go ahead and open it this once, but a property manager doesn’t want you using the restroom anymore,’” Arambula, 37, recalled.
Arambula, a trans man, will always wonder if his transition prompted the locked bathroom doors. It occurred in a complex where he knew everyone’s names and had delivered mail to them for years.
“I’m being turned away and I’m supposed to be an essential worker,” Arambula said. “They’re not going to tell you it’s because you’re trans, but, in the back of my mind, it’s going to be like, ‘but what if?’”
Franky Arambula photographed along his old delivery route in San Carlos, which mostly consisted of single-family homes. (Photo by Thomas Murphy/Times of San Diego)What is not in question is the dire health consequences the closure caused. His irritable bowel syndrome worsened, leading to prolonged absences from work.
The public bathroom is an amenity that dictates who can and cannot be part of public life. A healthy adult may be able to “hold it” if no bathroom is available, but it can exacerbate the marginalization of people with disabilities, gender non-conforming people and other groups who stay home, and out of public view, if no safe bathroom option exists.
Arambula’s doctor later diagnosed him with pelvic floor dysfunction, a condition found in some truck and delivery drivers. The doctor directly blamed holding it in for prolonged periods as the cause of the dysfunction, which could result in a lifetime of diaper use.
Arambula has grown more convinced of what happened. Yes, it was transphobic, he increasingly thinks. His physical appearance had begun to change just as the incident occurred. It was no longer just him announcing that he wanted to be addressed in a certain way. Now, his transition was physically manifesting through hormone replacement therapy.
Franky Arambula photographed along his old delivery route in San Carlos. (Photo by Thomas Murphy/Times of San Diego)“I stood out a lot,” Arambula said.
Arambula is not alone in experiencing life-altering health consequences from lack of bathroom access, nor is he the only gender-diverse San Diegan in the situation.
Cecile Ferrando, a urogynecologist at UCSD Health, has treated gender-diverse patients with kidney, bladder and pelvic floor issues attributed to not using the bathroom enough.
“There’s a lot of downstream consequences of not being able to access the bathroom throughout the day,” Ferrando said.
Surveys of transgender people have found bathroom avoidance in portions of the population, either from fear, anticipation of discrimination or trauma from past experiences. That has public health consequences.
“When patients either can’t access a bathroom or don’t feel safe accessing a bathroom, they’re much less likely to hydrate properly,” Ferrando said. “So fluid restriction is a real thing which can affect bladder and overall health. Access to a restroom is not just a convenience, it’s a basic health need.”
Franky Arambula attempts to open a locked all-gender bathroom at a Jack in the Box on Mission Gorge Road, a couple miles outside his old route. He said the Jack in the Box was a frequent stop for construction workers, landscapers, delivery drivers and other professionals who needed access to a bathroom. (Photo by Thomas Murphy/Times of San Diego)Mason Dunn, a contractor at the Naval base in Coronado, described rationing water even in the summer to avoid using the bathroom. His workplace, because it is on federal property, has legally obligated him since 2025 to use the bathroom of his sex assigned at birth, not his gender.
“I have to use the women’s restroom still, but because of how I look, I’m very cautious about going to the bathroom,” Dunn said. “So I try to go only once a day while I’m at work, if I can help it.”
He has yet to experience any health concerns related to this, but others have.
These health complications, either caused by or worsened by a lack of public bathrooms, make the challenges of being gender diverse in a world with mostly gendered bathrooms more difficult.
“It’s something that I wish I didn’t have to think about.”
Kuzon Itahana“On the rare occasion I find a specifically marked gender neutral bathroom, it makes me realize how much stress I feel having to deal with gendered bathrooms,” said Kuzon Itahana, a nonbinary 28-year-old.
Another local disabled transgender person, Jerry McCracken, limits travel to a 30-minute radius from his home in Chula Vista where he knows the locations of wheelchair accessible bathrooms in local businesses.
Jerry McCracken, right, photographed with Eddie Caballero, the owner of the Antique Row Cafe in University Heights. McCracken befriends business owners like Caballero to ensure he can find a bathroom when he needs one. (Photo by Thomas Murphy/Times of San Diego)McCracken transitioned in the ‘90s, before California law permitted people to use the bathroom that aligned with their gender identity. Instead, transgender people waited until they could blend in to use gendered restrooms.
“It was like ‘you’re not going into any public restroom. Period. End of statement. No. Either go at home or you hold it,’” McCracken said. “So there are members of the community who end up with UTIs.”
While laws have changed, legal rights and realities on the ground are not always aligned.
“You certainly can’t legislate against people expressing their fears in a way that’s discriminatory,” Ferrando, the urogynecologist, said.
At this point for the bushy-bearded and balding man, McCracken’s gender does not affect his bathroom use, but his disabilities, including Crohn’s Disease, diabetes and mobility issues, do.
Jerry McCracken in front of the all-gender bathrooms in the Antique Row Cafe in University Heights. (Photo by Thomas Murphy/Times of San Diego)For now, Itahana uses the women’s bathroom, but hormone replacement therapy could make that more difficult.
“I find myself starting to worry about eventually looking not-female enough for the women’s restroom, but… I also worry about getting called out in men’s restrooms,” Itahana said. “Being nonbinary definitely complicates public bathroom experiences.”
“Being nonbinary definitely complicates public bathroom experiences.”
Kuzon ItahanaSam Cay, who is also nonbinary, wishes there were more gender neutral public bathrooms available, ones that didn’t make them have to pick a gender they are not.
“I have to accept being misgendered in those bathrooms so that my basic need can be met,” Cay said. “Why does it have to be a compromise? Why can’t it just be a right?”
Sam Cay outside the Spanish Landing Park bathroom. As a safety measure, they puff out their chest while using the women’s bathroom, despite this causing dysphoria. (Photo by Thomas Murphy/Times of San Diego)Gender diverse people describe elaborate rituals to feel safe in the women’s restroom: Listening at the door to make sure it’s empty, puffing out their chest so women feel safe, having a female coworker sweep the bathroom to ensure it’s not being used, throwing on a large hoodie to disguise their appearance, not leaving the stall unless the bathroom is empty, carrying hand sanitizer to avoid using highly-visible sinks.
The men’s restroom has its own issues: Lack of stalls, lack of privacy, general dirtiness and safety concerns.
@zachwillmoreHappy new years, I guess I can’t win #fyp #new years
♬ original sound – ★ Star Boy ★On New Year’s Eve on a visit home to Missouri, San Diego State University student Zachary Willmore was accosted for being “dressed like a girl” in the men’s bathroom in a viral video that shocked viewers, while Willmore maintained the confrontation was far from an outlier.
“They don’t want transgender women to use the women’s bathroom,” Willmore said on his viral video. “They don’t want gay men to use the men’s bathroom. I guess I’ll just piss on the floor.”
Dealing with stares, comments, fear and discomfort from others can happen in any multi-stall bathroom, leaving gender non-conforming people with difficult choices.
“Do I bite the bullet and go to the bathroom nearby, in the women’s bathroom, or do I stick to my guns and go to a whole other building for a gender-inclusive bathroom?” Cay said.
For Cay, developing disabilities, including incontinence, took that choice from them.
“The stress has been so intense that I will take whatever bathroom at this point,” Cay said.
Cay’s incontinence has worsened since becoming unhoused, partially due to infrequent bathroom access. Cay may need to permanently use a catheter, which carries risks like infections and sepsis, particularly in their unsanitary living conditions.
Kuzon Itahana at the Old Town Transit Center on March 28, 2026. Despite being one of San Diego’s biggest transit centers, it does not have a public bathroom. (Photo by Thomas Murphy/Times of San Diego)Itahana now stays home due to lack of bathroom access like Cay once did. When forced to go out – either for work, necessary errands or from becoming unhoused – it led to worsening health.
Itahana did not develop bladder dysfunction until becoming unhoused.
Sam Cay outside the Spanish Landing Park bathroom. When Cay learned they would be living out of their car, the first thing they did was try to find bathrooms open to unhoused people. (Photo by Thomas Murphy/Times of San Diego)Many of the health concerns around lack of bathroom access exist for unsheltered people too, not just workers in fields like delivery driving. And becoming unhoused is not an outsized concern for gender diverse communities. In the most-comprehensive study of transgender people in the U.S., first published in 2015, 30% of respondents had been homeless in their lifetimes.
“I have bladder problems to this day because I would often have to wait long periods of time before I’d be able to get to a bathroom,” Itahana said.
Without a car, Itahana depends on a transit system with few bathrooms and long wait times between, which makes it difficult to plan a trip with bathroom access. Due to the frequency of their bathroom use, they often stay home.
Kuzon Itahana outside the locked employee portable toilets at the Old Town Transit Center on March 28, 2026. (Photo by Thomas Murphy/Times of San Diego)“It causes a lot of extra stress for sure,” Itahana said. “It’s something that I wish I didn’t have to think about.”
If there were more public bathrooms throughout the region, McCracken’s life would not be limited to the 30-minute radius it is now.
“I wouldn’t have to plan out every step of my day,” McCracken said. “I could just go, go out and do stuff like a normal human.”
Jerry McCracken in front of the all-gender bathrooms in the Antique Row Cafe in University Heights. (Photo by Thomas Murphy/Times of San Diego)Hence then, the article about for trans san diegans lack of public restroom access is causing lasting medical harm was published today ( ) and is available on Times of San Diego ( Middle East ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
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