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Urinary segregation is a term used by some to refer to the separation of public toilets into the sex categories of male and female. The term suggests a similarity to racial segregation. In the United States, sex-based separation of public restrooms began in the late 19th century as a response to women not having toilets available to them in the workplace. In contemporary times, this separation is typically enforced by both city laws and building codes. Key differences between male and female restrooms in most western countries include the presence of urinals for men and sanitary bins for the disposal of female sanitary waste for women.

The separation of restrooms along lines of gender, and the question of how social and legal enforcement of the division should take place, have been the subject of debate. Transgender people often face harassment based on their choice in restroom regardless of whether they use the restroom corresponding to their gender identity or their sex assigned at birth, which has led many activists in the transgender community to call for legal protection for people using restrooms which reflect their gender identity. Others have questioned the need for gender-based restroom segregation. In addition to transgender issues, those questioning the need for gendered bathrooms cite dilemmas caused by the need for caretakers of dependents (who include children, the elderly, and the mentally and physically disabled) to enter the restroom used by their charge, regardless of which restrooms they may use themselves.

Others, especially those subscribing to an essentialist view of gender, have proposed laws which require transgender individuals to use restrooms corresponding to their sex assigned at birth. Advocates of these laws claim that transgender people, or cisgender people claiming to be transgender, will be responsible for sexual assault in bathrooms matching their gender identity. However, statistics on sexual assault in restrooms show no incidence of assaults where the perpetrator was a transgender person using a restroom corresponding to their gender identity, while 70% of transgender people report facing harassment or assault while trying to use a restroom.

The origin of urinary segregation
"The first sex-segregated toilets were assembled in a Parisian restaurant for a ball held in 1739." Preceding this, public restrooms were "unmarked or marked for men only." The need to establish sex-segregated bathrooms in the United States arose from a lack of women's restrooms in workplaces, i.e. toilets were for men's use only and so there was a need to create some for women. It was in 1887 that Massachusetts became the first state in the United States to pass legislation requiring that any workplace with female employees be required to have a female specific restroom. In the 1920s most states had passed laws regarding sex-segregated bathrooms.

Why urinary segregation continues
American public restrooms are regulated by two separate federal agencies. The U.S. Department of Labor governs workplace restrooms while non-workplace restrooms are governed by the Department of Health and Human Services. Many places in the United States are actually "legally prohibited from offering only restrooms for men." Mary Anne Case points out "Even in public spaces, such as restaurants, where two single occupancy, self enclosed toilet facilities are all that is provided to customers, signs designate one 'Stallions' and the other 'Fillies,' one 'Pointers' and the other 'Setters,' or, more prosaically, one 'Ladies' and the other 'Gents.'" These regulations are mostly based on the precedent created by original legislation, though they also work to eliminate the longer wait time females often face by creating a ratio of more female restrooms than male restrooms.

Building code is another reason that Urinary Segregation continues. This is because buildings from different eras are subject to different codes. In many situations, building owners do not update existing features because it allows them to continue following the older building codes that go along with those older features.

The effect of urinary segregation on transgender people
Urinary Segregation brings about issues of both identity and safety for transgender people. The issue of identity is questioned because "walking into a toilet segregated by sex requires that each of us in effect self-segregate." Furthermore, some transgender people report being challenged on what bathroom they choose to use and subsequently "do their best to forego use of public toilets altogether."