Public toilet anxiety – a helpful guide for sufferer, washroom designer and facility management

Toilet phobia can affect anyone at any time and ranges from a minor distraction through to a significant disruption to daily life.

Personal experiences

I too have mildly suffered from this as a child.  I think we all have if we think about it.  But it can manifest in adulthood in varying degrees.  My particular experience was at primary school, when in a cubicle and certain individuals looked over the top and made fun.  This stayed with me for ages and I had a real fear of going to the toilet at school.

But apparently this is not an uncommon phenomenon for an unpleasant experience in a public toilet to stick with someone and affect how they perceive going to the toilet in public places as they grow.

Having to get off a bus because I’d drank too much water at a gym is another that springs to mind.  I had a real fear of wetting myself as was so desperate to get to a toilet. A fear of needing the toilet whilst on public transport was with me for a while after this.

I also on occasion get “stage fright” when standing next to someone at a urinal.  Not being able to go sometimes which leads to embarrassment and further anxiety.  As you will learn below this is quite a common phenomenon with the anxiety leading to a tightening around the muscles of the bladder, restricting movement.

If you too suffer from this kind of thing there is a web page from anxietyuk.org.uk dedicated to stories of people who have suffered or are suffering.  It is well worth a read to let you know you are not alone.

I now have no problem with public toilet usage, within reason.  But for others this is a real problem for them.

This post outlines those fears in a bit more detail and gives possible solutions of how public toilets can be designed or made more accessible to give some possible relief to sufferers of toilet phobias.

This of course should be treated like any other anxiety disorder, with careful psychological assessment and intervention relevant to the level of anxiety suffered.  I am not saying that the below is a quick fix cure.  Treatment for this can include CBT (Cognitive Behaviour Therapy), hypnosis, counselling and relaxation techniques amongst others.

This article is purely a guide for what’s available to ease some of the levels of anxiety suffered. It is also a reference for those responsible for washroom & public toilet design and those that offer public toilets, making them aware of the condition and how they can help alleviate some of the concerns through their design, planning and actions.

What is toilet anxiety?

ToiletAnxiety.org describe this as being:

“Toilet anxiety, or toilet phobia, is a term used to describe a number of issues related to using the toilet. It is a type of anxiety condition in which the sufferer may experience concerns and fears about one or more of the following:

  • Being unable to urinate or defecate
  • Using a public toilet
  • Being too far from a toilet
  • Having an accident in public
  • Other people being able to hear or see you use the toilet
  • The cleanliness of public toilets
  • Being confined in a small space”

All the above can be related to a number of other phobias as Phobia Guru states, such as Mysophobia (a fear of germs), Claustrophobia (fear of small spaces), and Emetophobia (fear of vomit), so it can be a complex situation.

Some possible solutions

Fear of being too far from a toilet or having an accident in public.

When you are out and about, there is nothing worse than not knowing where the nearest toilet is to you.  This effects some peoples social and work lives as they fear that they can not go to certain places because they do not know where the toilets are and what state they will be in.

Planning ahead could be a way of minimising any anxieties and calming the mind before travelling to any location.  As part of a routine it could become a great coping strategy for some cases of toilet phobia.

There is a major decline in the UK of available, council run public toilets.  Facts collated by the BBC show UK councils stopped maintaining around 13% of public toilets between 2010 and 2018 and in 37 areas, major councils no longer run any public conveniences.

Community Toilet Schemes (CTS) have been set up around the UK, asking for businesses and public venues to offer their toilets to the general public.  The types of buildings to offer the service include pubs, restaurants, libraries and shops.  Some businesses can also receive funding to allow people to use their facilities free of charge without having to make a purchase.

CTS are developing in towns and cities such as Bristol, City of London, Edinburgh, Stockport, Sheffield, Oxford and Portsmouth to name just a few.  The British Toilet Association is campaigning to bring all the CTS together with one directory and signage as it is a bit fragmented at the moment.

With the lack of one direct source of CTS information, websites and apps have been developed that not only provide the locations of public toilets, but reviews by users so that you can have some reassurance of the cleanliness and accessibility.  Some even provide pictures!  Users can also add new toilet locations to the sites and apps so that the database is continually growing.

Websites and apps examples*

* Please note at the time of writing we are not associated with any of the above apps, websites, companies or authorities and therefore provide the links as reference only.  We do not endorse any of the content of any link provided and can not be held responsible for any of its usability or content.

Fear of other people being able to hear or see you use the toilet

This can lead to not actually being able to go to the toilet when you get in a washroom because there are too many people around.  When you need to urinate but can’t it’s called “shy bladder” or technically, paruresis. Over 20 million Americans suffer from it, so if you have had a moment like this you can rest assured you are not alone.  Although again, the degree of severity varies in each person.

At the opposite end (pardon the pun), is the inability to defecate when others are around. This is called “shy bowel” or parcopresis

The Japanese have this covered, catering for embarrassing noises that can arise from a cubical.  Toilets that have a button to press which creates a flushing sound were originally designed with the female user in mind.  However, I’m sure these will have been used by males throughout the country.  The ideal is that a flushing sound can be heard on the outside of the cubical, but what is actually going on is the strain of a bodily function.

Of course, these are an advanced technology that may not be ready to launch in other parts of the world, but the idea that external sound over embarrassing noises can be adapted in other ways.

Schools in Sweden have been lobbied with the challenge from a local council to install music in toilet facilities as it has been noted that, as I’m sure in many schools around the world, students fear going to the toilet from being heard on the outside of the cubicle.  This is certainly one way that a facility could help alleviate anxieties by adding some covering sound.

A hand dryer, even the quiet varieties, creates enough noise for a toilet goer to time their bodily function with the precise moment the hands are being dried.  Another good reason to place a hand dryer in a public facility you may say.  Total silence can be an unwanted requirement in a public washroom.

In male toilets, the urinal area can be a place of anxiety when people are in close proximity.  The washroom designer would be well advised to, where possible due to space, always add the addition of partitions between them.  This may well be advisable to include single urinals rather than the trough urinals you get in places, to consider those with a toilet phobia.

For added privacy, toilet cubical doors can be made from floor to ceiling so that there are no spaces to look over or under the cubical.  There may be some concern here as the lower cubical partitions are there as a safety feature, especially in schools.  Locks with access from the outside via a screw driver or coin are available, although this would not stop a naughty child using this for their own amusement.  An option is there but would need careful consideration.

Fear of the cleanliness of public toilets

If you are providing a public toilet then the minimum standard should be cleanliness.  The state of your washroom facilities can give the overall impression that you either run a very clean and healthy building, or the extreme opposite.  This could be a major factor in how people judge you and whether they will return. Regular checks should be made on the basics such as toilet rolls stocked up, clean toilet, floor clear of mess etc.

This video shows a method of how to clean your toilets.  Carrying this out on a regular basis can certainly help decrease peoples fear of using the facility due to how dirty it is.


Jangro provide eLearning opportunities via their website to get your staff trained in topics such as Floor Care, Manual Handling, Control of Substances Hazardous to Health (COSHH) Awareness etc. 

We have yet to take one of the courses ourselves so can not comment fully on the content, but on first glance they look to be really valuable.

The Jangro Learning Management Solution (LMS) recommended for this blog post is “Washroom Hygiene”

It is easy to sign up to this course online and you can do so via this link here

If you have anything to add relating to the above, or any information that we can add into this to make it as valuable as possible, please do not hesitate to contact us or leave a comment below.


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Written by: James Marvin

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