The trend towards desegregated women’s and men’s toilets, including installing Gender Neutral Toilets (GNTs), and the implications of revisions to the Gender Recognition Act for women-only spaces, have brought into focus the pre-existing lack of female toilet provision in the UK. Looking at the problem from a town planning perspective, I argue that austerity-driven cuts are coming together with GNT provision to reshape the public toilet landscape in ways that continue to be detrimental to women. Typically women are only provided with half as many facilities as men, resulting in queues for the Ladies, and GNT provision based on relabelling rather than redesigned or additional provision can, in fact, increase competition for the cubicles in the Ladies. The historical, legislative and cultural reasons for this inequality are explored, along with the different types of public toilet and the different requirements of male and female users. The article draws on previous research project findings, many of which foreshadow the problems currently coming to the fore as a result of toilet desegregation. In conclusion, recommendations are made as to how to deal with the conundrum of providing adequate facilities for all women and men, whilst providing all sorts of individuals with choice and privacy to create inclusive, accessible cities for all.