Access to inclusive public-toilet options and the wellbeing of trans and gender diverse employees: Novel evidence from a large Australian workplace survey

Abstract

Background: Inclusive public-toilet access by trans and gender diverse (TGD) individuals has been the subject of intense public and legislative debate. This study offers first-time evidence on the associations between TGD people’s ability to use toilets of choice and access all-gender toilets within the workplace and their health and wellbeing. Methods: We analyze data from TGD respondents to the 2024 Australian Workplace Equality Index Employee Survey (n = 1020). The focal explanatory variables capture respondent-reported freedom to use toilets of choice and availability of all-gender toilets at work (range: 1–5). The outcome variable is a composite index of employee wellbeing (range: 0–100). We model their relationships using random-intercept multilevel regression models adjusted for an encompassing set of individual- and employer-level confounds. Results: Having access to toilets of choice (β = 6.54; 95%CI: 5.41,7.6) and all-gender toilets (β = 3.02; 95%CI: 1.99,4.05) exhibited large and statistically significant effects on TGD employee wellbeing. These relationships were apparent among binary and non-binary trans employees, and across employee-wellbeing domains. Conclusions: Appropriate access to public-toilet facilities must be incorporated within ongoing policy efforts to improve the wellbeing of TGD individuals and redress entrenched health disparities for this population. This includes guidelines being currently developed by the World Health Organization.