For some people, a bathroom can make all the difference.
Two years ago, a woman in the women's restroom at City College of San Francisco accused Nadia Cabezas of being a man and slapped her across the face.
But Cabezas was not a man – she was a transsexual student, who was born male, but identified as female.
The incident prompted transgender music Professor Bob Davis, who identifies as female, to launch a campaign to add a third kind of restroom to the campus: one that was not male, not female, but gender-neutral.
The school – which now has gender-neutral restrooms in nine of 13 buildings – is among a growing number of colleges and grass-roots organizations working to increase the number of bathrooms that could be used by either gender.
"It boils down to safety," said Alexis Rivera, policy advocate at the Transgender Law Center in San Francisco. "People who don't feel comfortable necessarily using the male or female bathroom need to have the option to use the gender-neutral restroom."
A San Francisco Human Rights Commission survey found that about 99 percent of nearly 500 trans and non-trans people want gender-neutral bathrooms for various reasons.
Transpeople specifically want them because they've been targets of harassment in gender-specific restrooms. Some were even escorted out by security, said Bailey Stevens, co-founder of www.safe2pee.org, which lists gender-neutral bathrooms across the country.
Almost half of the transpeople who responded to a 2002 San Francisco Human Rights Commission survey reported they had experienced assault or harassment in restrooms.
However, not all transpeople want to use gender-neutral restrooms, said Shannon Minter, legal director of the National Center for Lesbian Rights based in San Francisco.
"Transsexual people would generally just like to use the bathroom that corresponds to their gender identity and the other [genderqueer] folks would prefer to have a gender-neutral bathroom available," Minter said. "It's important to accommodate both groups."
Minter has worked with numerous colleges across the country to designate some single-occupancy restrooms as gender-neutral. He estimates that more than 90 campuses have gender-neutral restrooms, usually in compliance to the school's non-discrimination policy.
He also presents a workshop on the rights of transgender students, including restroom rights, at an annual conference for college administrators. He has been giving the workshop for 17 years, he said, but the movement is just now starting to gain momentum.
In addition to City College of San Francisco, other Bay Area schools with gender-neutral bathrooms include the University of California-Berkeley, the New College of California and California College of the Arts.
Some schools, such as the University of Arizona, have had gender-neutral bathrooms for several years. The school recently added more after the university incorporated gender-identity protection into its non-discrimination policy.
Campus leaders at the private Pomona College recently changed the signs on about half the men's and women's restrooms in the dorms, although students have informally designated some dorm restrooms as gender-neutral for years.
The signs now list what is inside the room – such as two stalls, two showers – in place of which gender is permitted to use the facility.
Some schools even list on their Web sites gender-neutral bathrooms. These schools include the University of Texas-Austin, the University of Vermont, UCLA and UC-San Diego.
Davis uses the list of the gender-neutral bathrooms at the City College of San Francisco when she recruits students from transgender organizations and communities to show that "the school is aware of their needs," she said.
Five colleges - American University, New York University, Ohio State University, UC-Santa Barbara and Washington State University – have committed to including gender-neutral, single-occupancy restrooms in all future buildings, according to Minter.
School districts, on the other hand, have been slower to adapt. Because most junior high and high schools don't have many single-occupancy restrooms to convert, providing gender-neutral bathrooms for students can be difficult.
Instead, several school districts have adopted policies that allow transgender students to use the restroom that corresponds to their gender identity, even if it differs from their birth sex.
The San Francisco Unified School District and the Los Angeles Unified School District recently adopted such policies. Minter said it will be an "uphill battle" to get other school districts, especially in conservative states, to implement similar policies. But, he said, "it will only be a matter of time before it's absolutely standard to have gender-neutral bathrooms along with the more conventional division" at all schools.
Minter has also worked with businesses to create gender-neutral bathrooms and ensure the rights of transpeople to use the restroom of their choice. Employers and employees have been contacting the organization, he said, as gender-neutral bathrooms grow in popularity.
"In restaurants and airports and other places where the public is in and out, it is increasingly common to have a gender-neutral bathroom," he said. "It's quite silly to label single-occupancy bathrooms as either male or female. It serves no purpose at all."
But how do people find out about these bathrooms? Enter www.safe2Pee.org.
Stevens and two other co-founders launched www.safe2pee.org in December. The directory lists entries for 870 bathrooms in more than 260 cities in the United States, Mexico and Canada.
Anybody can to add entries to the directory, search for bathrooms and have restroom locations in a particular city or ZIP code sent to their cell phone.
The group hopes to expand the site to include listings worldwide, although Stevens says the need for a directory of gender-neutral bathrooms "is especially an issue in North America," where there tends to be fewer such restrooms.
Another organization, the Transgender Law Center, is working with businesses and schools to designate single-occupancy restrooms as gender-neutral.
In response to numerous requests to do something about bathroom harassment, the San Francisco-based center published "Peeing in Peace: A Resource Guide for Transgender Activists and Allies."
The extensive guide includes information on the history of bathroom segregation, the process of persuading schools and businesses to designate bathrooms as gender-neutral, as well as tips on how to deal with harassment in the bathroom.
The center plans to approach schools, universities and businesses and encourage them to use the guide.
"It's basically identifying the restroom at the location and switching the sign and making sure all administrators and employees know why it's important that there is another option," Rivera said.
In San Francisco, at least, the group has the law to back up its requests. In 2003, the San Francisco Human Rights Commission added a stipulation to its compliance rules regarding gender identity discrimination that "strongly urges" businesses and other institutions to provide a gender-neutral bathroom to employees.
On the national scale, federal lawmakers are considering at a bill that would prohibit workplace discrimination, the Employment Non-Discrimination Act.
Although the bill does not include a specific provision about gender-neutral restrooms, Minter said, "the law will require employers not to discriminate with regards to bathrooms," and mandate that they allow employees to use the restroom that corresponds to their gender identity.
But Minter said the best way to end discrimination and promote gender-neutral restrooms is not through legislation, but education – the same kind transgender and student groups have been doing for years.
"People are really receptive when they understand this is really an issue about safety and dignity and practicality," he said.