Teddy Siegel is the creator of a popular TikTok account that highlights hidden gems in New York City. But she doesn’t review up-and-coming restaurants, or scope out trendy bars. She runs got2gonyc, a guide to the free public restrooms in the five boroughs.

You may not expect it, with video titles like “Come Pee With Me in Bloomingdale’s,” but Siegel is performing a vital public service. There are currently just over 1,000 public toilets in New York City—and per one report, only two of those are open 24/7. And while New York is the most notoriously bathroom-deficient city in America, it’s hardly unrepresentative. A 2021 report found the United States has only eight public toilets per 100,000 people. Iceland has 56.

The lack of public restrooms in the United States isn’t just an inconvenience. It’s a sign of America’s failure to invest in communal necessities for the collective good. But progressive leaders at the local level have the power to change that.

They have done it before. In the aftermath of the Industrial Revolution, “sewer socialists” were elected on platforms that advocated for basic necessities, including sanitation systems and accessible bathrooms. Milwaukee’s socialist mayors were incredibly effective in channeling “public funds for the public good,” as one Milwaukee historian put it. Even today, Milwaukee boasts one of the highest numbers of restrooms per capita. Meanwhile, at the federal level, during the New Deal, the Works Progress Administration facilitated the construction of millions of outhouses in rural parts of the country.

So where did our public restrooms go? Over the decades, many cities acknowledged that such facilities were a necessity—but didn’t set aside the budget to operate them for free. By 1970, there were more than 50,000 pay toilets, which full-bladdered Americans could use for a fee. Around that time, an activist group called CEPTIA, the Committee to End Pay Toilets in America, was founded by a group of Ohio high school students who resented the idea that anyone would have to spend money for this basic human need. Leading a grassroots campaign fueled by self-aware humor, CEPTIA succeeded, in a sense. By 1980, most of those 50,000 pay toilets were gone—but in many cases, free toilets were never built in their place.

This is because it’s never actually been about the bathrooms but rather what they represent: an unintentional (and miserably inadequate) substitute for a broader investment in public space. Without safe injection sites, for example, drug users often resort to public bathrooms as one of the only freely-accessible spaces that offer privacy in this country. As Lezlie Lowe, author of No Place to Go: How Public Toilets Fail Our Private Needs, writes: “Bathrooms end up being used for people to meet their needs, whether it’s dependency or desperation.”

Hence the fearmongering about sex workers, drug users, homeless people, and crime that we hear from community boards when cities attempt to build new bathrooms. In America, bathrooms have become breeding grounds for an anxiety of the unknown.

Of course, public restrooms don’t create these problems. At worst, they make them visible to those who could previously ignore them. But the alternative—forcing people to urinate or defecate in the streets—cannot be an option.

Nor can we rely on private businesses pick up the slack. In 2018, two Black men were arrested in a Philadelphia Starbucks after asking to use the restroom (without purchasing an overpriced macchiato first!). In the aftermath, Executive Chairman Howard Schultz said, “We don’t want anyone at Starbucks to feel as if we are not giving access to you to the bathroom because you are less than.” But last summer, the coffee conglomerate changed its policy: Now, employees can decide to close the restroom if they have safety concerns.

The controversy over Starbucks belies a more fundamental issue: we shouldn’t expect private companies to provide this public service. This is a job for local governments. And despite threats to stall, some cities have major developments coming up the pipeline.

The New York City Council has proposed a four-year plan to quadruple the number of public restrooms in the city. This would provide one restroom for every 2,000 New Yorkers—a significant improvement from the current rate of one for every 7,700. And in San Francisco, the Pit Stop program has successfully piloted 24/7 public restrooms equipped with paid staff in areas with high rates of homelessness. Since then, reports of public feces in San Francisco have declined.

The 1970s bathroom activists may not have met all their goals, but modern-day restroom revolutionaries are following in their footsteps. Steven Soifer, President of the American Restroom Association, advocates for gender-neutral private stalls for people with paruresis (or shy bladder syndrome). These have the added benefit of providing a safe space for parents with children, transgender and nonbinary people, and people with special needs. The ARA successfully campaigned to amend the International Plumbing Code in 2021, which means more of these inclusive, accessible restrooms will soon become available around the world.

Soifer says, “The state of a country’s civilization can be judged by their toilets.” By that standard, America is far behind Europe and about on par with Botswana. But thanks to relentless activists and some modern-day sewer socialists, hope may not be down the tubes. What a relief.