In his 1937 essay What is a City?, historian, sociologist and architecture critic Lewis Mumford described the city as a theatre — a space in which the social drama of urban life could play out.

It's unlikely he envisioned the daily drama of parents with young children, the sick, and the weak-of-bladder looking in vain for an accessible public toilet.

According to journalist Lezlie Lowe, it's a struggle that's all too common — testament to the decline in public toilets.

In her book No Place to Go: How Public Toilets Fail our Private Needs, Lowe argues that the state of our public toilets tells us a great deal about what kind of cities and what kind of society we want to be.

The automated toilets that now dot the urban landscape suggest a rather bleak compromise.

Recently revamped public toilets at Melbourne's Flinders Street Station have been dubbed a big "relief" for members of the public. ( Supplied: PTV )

The self-cleaning silver kiosks function increasingly as a kind of anti-facility, designed to minimise messy human reality as much as possible.

The toilets have no seats, to prevent them being defaced or ripped out; they are lit with blue UV lights, to deter drug users; their doors are designed to open automatically, to discourage lingering; and they are almost chronically lacking in soap and paper.

"When automated flushers and [taps] and hand dryers stop working, no human is there to know except the users — who have, precisely as a result of automation, been alienated from the space and feel no need to … report, for example, a non-flushing and rapidly filling clogged toilet," Lowe told RN's Blueprint for Living.

It's hard to imagine a more abject illustration of the failure of economic rationalism in urban design than a hapless individual interrupted while trying to relieve herself, by an automatically flushing toilet that flushed too soon, and automated doors that open unprompted to expose the unfolding drama within.

The inadequacy of public toilets today, Lowe argues, indicates an abandonment of both municipal responsibility and social solidarity:

"The very recent history of public bathrooms in cities has been a history of who gets to have space in our cities and who lacks space in our cities ... who gets to use public facilities and who does not," she says.

The male and female figures might be most recognisable signage symbols in the world. ( Giulio Saggin: ABC News )

But it was not always thus. Once upon a time, ornate public toilets in the US, UK and Australia reflected a broader commitment to public health.

"That was a time when there was this great Victorian concern with public health, which is to say, public provision and making everybody healthy and happy," Lowe said.

"What [everybody] meant in the 19th century was men ... Men needed to have public bathrooms because men were out and about in the city and men were on their way to work and so men needed spaces to relieve themselves.

"So [while] it was quite a heyday, and there are these legacies of gorgeous Victorian-era loos in so many cities ... often we see women were left out of that."

The commodification of a basic human need

The decline can roughly be traced back to the advent of car culture, says Lowe. Petrol stations, often in city centres, and typically equipped with bathrooms, relieved government of the responsibility to provide public toilets.

"But what happened eventually... is that [centrally located service stations] were less and less commonly seen ... and we [had also] lost our on-street accessible public bathrooms."

Pop-up public toilets from Netherlands company Urilift, a modern riff on the public urinals that became common in Western Europe in the 19th Century. ( Urilift )

In recent times, she says, the advent of coffee culture saw "almost a bathroom renaissance" — "Starbucks is the new bathroom".

Generally these days, in the absence of public toilets, people are instead encouraged to use cafes, pubs and shopping centres.

In other words provision for one of the most basic human needs has been commodified.

Social exclusion is the inevitable effect — if you can't afford the $4.50 latte, if you are homeless, or if you simply look 'undesirable', you have, in the words of Lowe, "no place to go".

"A lot of us don't see bathrooms that way ... we see bathrooms as this neutral space ... but when you stop for a second ... and think about the ways that bathrooms change the way [you] use the city, it actually tells you a lot about how much access you have."

An issue of access and equity

Lowe started writing about public bathrooms a long time ago because she had young children.

Nothing brings the issue into sharper relief than a child looking up at you in desperation, saying they need to go, she says.

"I recognised that I was changing the way I used the city because I always had to have bathroom radar.

Surfers Paradise bus shelters that have been repurposed as public toilets. ( Supplied: ACT Bus )

"So I started looking at different people, for example, people who have Crohn's or Colitis. Their entire day may be structured around where [they] can go, where [they] know [they] have instant access."

Of course, people with serious health conditions are just the pointy end of the problem. Lowe quotes one estimate that suggests when you include the elderly, parents with children, and menstruating women, roughly a quarter of the population has special bathroom needs.

"That's a really fascinating way of seeing bathrooms.

"[Because] actually a lot of us structure our lives around public bathrooms."

A gendered problem

While there are many layers of injustice and exclusion at work in the design and provision of public toilets, gender inequality has been one of the most enduring, says Lowe.

"Even when public space is equal for men's and women's [bathrooms], men often get more provision. Where women get six cubicles, men might get four cubicles plus four urinals", she writes in No Place to Go.

"But that's not where the inequality ends. Women, biologically, need more provision. For one thing, they take longer to empty their bladders ... [And] women use the bathroom more frequently than men. Again, biology: women menstruate, women can be pregnant."

The ongoing failure of our public facilities is, in part, the result of our reluctance to confront some profoundly challenging social problems.

As Lowe writes, "Public bathrooms are private spaces that reveal public truths".

It is not simply our bodily needs that give rise to our discomfort. Talking about public toilets, Lowe suggests, would require us to confront the structural inequalities embodied in our built environment, the problems of homelessness and dignity, of gender, and ultimately of how we share (and fail to share) public space.

The solution, according to Lowe, must begin with an acknowledgement of the social and political dimensions of our most mundane public spaces.

"When we talk about liveable cities, and when we talk about accessibility, what we're talking about, in part, is public bathrooms."

Lezlie Lowe is author of No Place to Go: How Public Toilets Fail our Private Needs (Coach House Books).