A/HRC/42/47 space and designed so they can be accessed safely and securely. 29 That includes consideration of the period when facilities are open, since many public toilets close at night, which is problematic for people who rely exclusively on them. 43. A particularly salient consideration that must be borne in mind when determining how to guarantee accessibility is the promotion of access to groups that are usually marginalized and who live in vulnerable situations, including persons with disabilities, the elderly, children and members of the lesbian, gay, bisexual, transgender and intersex communities. In order to be deemed physically accessible, water and sanitation facilities in public spaces must meet the needs of all of those groups on an equal footing with everyone else. 44. Accessibility concerns are, for instance, highly prevalent for members of the transgender community. Studies on the experiences of people who are transgender show that they are commonly denied access to public toilets which match their gender identity, forcing them to use those that match the gender they were assigned at birth. That denial of access can have a negative effect on their mental health and may put them at risk of attack and abuse. 30 To combat that risk, a number of States have sought to ensure greater accessibility for marginalized people seeking access to public toilets. In Canada, an act to amend the Canadian Human Rights Act and the Criminal Code, passed in 2017, facilitates the prohibition of discrimination based on “gender identity or expression” thereby enabling transgender people to utilize public toilets that match their gender identity. 31 In Nepal, third-gender public toilets have been introduced to provide facilities for transgender and non-binary people, and are preferred to gender-neutral toilets because the complete exclusion of men in third-gender toilets helps to promote the safety of transgender and nonbinary users.32 Studies in relation to the Nepali experience note that users of third-gender public toilets in Kathmandu are broadly satisfied by the facilities, particularly when they are placed in public locations, such as near bus stops, as it is felt that decreases the risk of discrimination and attacks.33 45. Equally, persons with disabilities often struggle to find water and sanitation facilities that are appropriate to meet their needs, which greatly limits their ability to utilize public spaces and engage in social activities and is particularly worrying for homeless persons with disabilities. 34 In relation to increasing the accessibility of public toilets for persons with disabilities, authorities in both the United Kingdom and Australia have introduced “changing places” toilets in public spaces, which are specifically designed and built for people requiring a high level of assistance when using the toilet and contain all the equipment needed to ensure persons with severe disabilities can use toilets safely and with dignity. 35 In 2006 in the United Kingdom, Nottingham Council installed a “changing places” toilet in the city centre. It is noted that this toilet allows persons with significant disabilities to make use of the city’s amenities, without the barrier of being unable to access public toilet facilities that meet their needs. 36 29 30 31 32 33 34 35 36 12 See Committee on Economic, Social and Cultural Rights, general comment No. 15, para. 12 (c) (i). See Sandy E. James and others, The Report of the 2015 US Transgender Survey (December 2016). See also submission from the International Commission of Jurists. See an Act to amend the Canadian Human Rights Act and the Criminal Code (S.C. 2017, c. 13), s. 3 (1). See C. Benjamin and A. Hueso, “LGBTI and sanitation: what we know and what the gaps are” 40th Water Engineering and Development Centre international conference, Loughborough, United Kingdom (2017). Paul Boyce and others, “Transgender-inclusive sanitation: insights from South Asia”, Waterlines, vol. 37. No. 2 (April 2018). See Rob Kitchin and Robin Law, “The socio-spatial construction of (in)accessible public toilets”, Urban Studies, vol. 38, No. 2 (February 2001); Jo-Anne Bichard, Julienne Hanson, “Cognitive aspects of public toilet design”, conference paper (2005); and Yasemin Afacan and Meltem O Gurel, “Public toilets: an exploratory study on the demands, needs and expectations in Turkey” Environment and Planning B: Urban Analytics and City Science, vol. 42, No. 2 (January 2015). Astor Bannerman, “How to achieve an accessible changing places compliant room layout” (2017). See www.changing-places.org/install_a_toilet/case_studies/nottingham_city_council.aspx.