Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

John E. Pachankis

Second Advisor

Joel Sanders


Introduction: Gender minority individuals, including university students, experience worse mental health compared with cisgender individuals. Although there are many factors that may shape these mental health disparities, inequitable bathroom access is one known factor. Therefore, the purpose of this thesis is to explore how campus bathroom use influences the mental health of gender minority students compared with cisgender students. Specifically, this study examines how discordance in bathroom preference and bathroom use is associated with mental health.

Method: This was a cross-sectional online study administered across three universities in the United States. Participants (N=120) completed an online survey. Respondents answered questions about mental health, bathroom preferences, and bathroom use across three bathroom types: 1) sex-segregated, multi-user, 2) all-gender, multi-user, and 3) single-user. The sample included 23 (19.2%) gender minority students.

Results: Using linear and logistic regression models, this study found that gender minority students were more likely than cisgender students to experience poor mental health as a result of campus bathroom use (B = 1.28, 95% CI = 0.61-1.94). Unexpectedly, discordance between bathroom preference and most frequent type of bathroom usage was protective of mental health (OR = 0.29, 95% CI = 0.10-0.86), but gender did not moderate this association. In addition, findings suggest that both cisgender and gender minority participants prefer single-user and all-gender, multi-user bathrooms over sex-segregated, multi-user bathrooms.

Conclusions: Findings highlight that inequitable bathroom access contributes to mental health disparities between gender minority and cisgender individuals. Implications for universities include renovating or constructing more inclusive bathrooms across campuses.


This is an Open Access Thesis.

Open Access

This Article is Open Access