Single-Occupancy Restrooms Only in New Buildings - Shy Bladder Syndrome and Much More - 2018 International Plumbing Code






Click box above for PDF drawings of private restrooms with less square footage than multi-stall per the 2018 code


Up to 46 million Americans are unable to urinate in the presence of others. Shy Bladder Syndrome (paruresis) is the name for this condition.

In buildings designed with multi-stall restrooms, paruresis sufferers find it difficult or impossible to urinate when others are in the same room.  Toilet stalls, urinal partitions or background music often do not provide relief.  This environment damages the quality of life people expect while functioning in society.  Ability to work or maintain employment can be affected. Paruresis can lead to agoraphobia or even to suicide.  

Single-occupancy (private) restrooms can require less square footage than multi-stalls. They do not need a dedicated room for the public to move around in and not bump into one another.  Egress corridors, lobbies and other common areas provide this circulation area at no additional cost. 

Single-occupancy restroom and bathing rooms designed around the 2018 International Plumbing Code, Section 403.1.2, are required to be unisex.  Alternative means and methods, variances, modifications or state code committees can allow it in advance of any state-wide approval. 

Designing multi-stalls with a separate family restroom is not the answer due to more square footage often required, waiting lines and labeling of those using them - pee shy, transgender. etc. Men can be reluctant to use a family restroom as being a ladies' room.

Designing unisex, multi-stall restrooms with floor to ceiling toilet partitions and shared sinks in the circulation area are not appropriate either. These are dangerous with both sexes being in the same facility, generally take more square footage than do private restrooms and can still hinder paruresis sufferer's ability to function. Manufactured, full-height toilet partitions are also expensive.          

The 2018 code helps paruresis sufferers, provides safer environments for families with children, helps disabled persons with opposite-sex caregivers, reduces waiting lines for everyone (potty parity) and solves state bathroom bills by birth certificate.

The National Organization for Women, a proponent for more single-occupancy, unisex restrooms, asks that toilet seat covers and hand soap dispensers be maintained in these facilities per their support of the 2010 Bipartisan Restroom Gender Parity in Federal Buildings Act. 

In new designs, architects can reduce the total building size where single-occupancy restrooms require less space.  The resulting energy savings pay back an estimated 10% additional cost of the private restrooms in the above floor plans as examples - for more doors, walls, etc.  Send a message for a cost differential.      

With all restrooms being single-occupancy, employee and customer satisfaction can increase leading to better productivity and increased sales.  Buildings become user-friendly, inviting, more in demand and an environment people can function in.  

The Americans With Disabilities Act includes mental impairments which is what paruresis is. The 2008 ADA Amendments Act (ADAAA) and the 2011 EEOC interpretations make paruresis even easier to prove as a disability that could lead to costly implications

Clearly, architects must design single-occupancy restrooms only in new buildings.     


The American's With Disabilities Act (ADA) Title III PROHIBITION OF  DISCRIMINATION BY PUBLIC ACCOMMODATIONS:  "(a) General Rule.--No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation."  ADA also states that a person is "considered to have a disability if he or she has a physical or mental impairment that substantially limits one or more major life activities."


A Study by Williams and Degenhart - Journal of General Psychology 51:19-29, 1954, found 14.4% of the population having paruresis, equaling 46 million Americans, based upon the 2015 USA population of 320,098,857.  A Harvard University Study - Social Phobia Subtypes in the National Comorbidity Study - American Journal of Psychiatry, 155:613-9, May 1998, found 6.6% of the population with paruresis equaling 21 million Americans as of 2015.