Live long enough and you find that what’s old is new again. When the Equal Rights Amendment to the Constitution, passed by the US Congress in the early 1970s, was making what seemed to many of us as its inexorable way through state-by-state ratification, it was stalled and then stopped, failing to meet an extended deadline by 1982, when its opponents raised the specter of federally mandated unisex bathrooms.

Now the extension of legal protections for transgender people has been blocked by another round of Americans’ potty paranoia. “History doesn’t repeat itself,” Mark Twain observed. “But it rhymes.”

Infamously North Carolina’s HB2, which voids local gender ordinances and requires bathroom use according to one’s “biological” sex assigned at birth, is only one such legislative initiative.

That law would include Aydian Dowling, a Men’s Health magazine cover model in 2015.

Imagine him adhering to the law by using the women’s room?

The prospect of a potty police to provide toilet surveillance would be laughable were it not that such laws have demonstrably negative health consequences for transgender people.

One recent study by Kristie Seelman associates bathroom constraints with suicidal thoughts: “Transgender university and college students are at a significantly higher risk for suicide attempts when their campus experience includes being denied access to bathrooms and gender-appropriate campus housing,” according to a press release by Georgia State University.

Using the framework of the minority stress model, the Institute of Medicine (2011) has already documented the vulnerability of transgender people:

• LGB youth are at increased risk for suicidal ideation and attempts as well as depression; small studies suggest the same may be true for transgender youth.
• Almost no research has examined substance use among transgender youth. Limited research among transgender adults indicates that substance use is a concern for this population.
• Some research suggests that young transgender women are also at significant risk for homelessness.
• Limited research suggests that transgender elders may experience negative health outcomes as a result of long-term hormone use.

What most of us take for granted (simply locating a bathroom, hoping it’s not fully occupied, and counting on finding toilet paper and towels), becomes a conscious and often fraught experience for transgender people. Several years ago, as I was leaving a classroom with one of my transgender students walking ahead of me, I observed her pause, looking at the women’s room and then at a unisex single-toilet bathroom beside.

Imagine having to face that decision every time you gotta go.