A/HRC/33/49 based on gender norms. Recognizing that young people may grow up to be change makers, curricula in all schools should challenge gender stereotypes and encourage critical thinking. 30. People who do not conform to a fixed idea of gender may experience violence and abuse when using gender-segregated sanitation facilities. Gender non-conforming people face harassment in or avoid gender-segregated public toilets altogether out of fear. For example, transgender girls who use the boys’ toilets and transgender boys who use the girls’ toilet in schools are highly vulnerable to bullying, harassment and assault by other students. 33 Research from India indicates that transgender persons face difficulties in finding rental housing and are often forced to live in remote slum areas, where access to water and sanitation facilities is poor.34 31. States must take all measures necessary to remove the barriers that deter people from using sanitation facilities. A concerted approach is needed against violence based on gender identity and initiatives must aim to increase respect and acceptance throughout society. A basic level of recognition of rights is needed. Too many States have laws that punish people on the basis of their sexual orientation and gender identity and expression. States should attach considerable importance to training and supporting teachers and administrators on non-violent learning environments. Malta, for example, has enacted guidelines35 for schools to promote the learning of human diversity that is inclusive of trans, gender-variant and intersex students, promoting social awareness, acceptance and respect. 36 D. Quality, health and safety issues 32. Levels of access to water and sanitation services affect men and women unequally. Because of their domestic roles and responsibilities, women are in greatest physical contact with contaminated water and human waste. 37 Women and girls who hold their urine for long periods of time have a higher risk of bladder and kidney infections. In addition, they tend to avoid consuming liquids to prevent having to use the toilet, as a result of which many become dehydrated. 33. Quality standards must take into account the fact that the amount of toxic substances to which a person can be safely exposed differs widely depending on the individual. Pregnant women in particular can be at higher risk of waterborne diseases from an intake of contaminated water. Standards on water, sanitation and hygiene quality must take into account the fact that women, especially when pregnant, have a lower tolerance for toxic substances.38 34. Soap and clean water for personal hygiene is of particular importance during menstruation. Women and girls must be able to use clean materials to absorb or collect menstrual fluid, and change them regularly and in privacy. They must have access to water and soap to wash their hands and body and facilities to dispose safely and hygienically of menstrual materials like pads, cups, cloths and tampons. Facilities must be easy to maintain 33 34 35 36 37 38 10 Human Rights Watch, submission to the Special Rapporteur. Water Supply and Sanitation Collaborative Council and Freshwater Action Network South Asia, Leave No One Behind: Voices of Women, Adolescent Girls, Elderly and Disabled People, and Sanitation Workers (2016), p. 15. Neela Ghoshal and Kyle Knight, Rights in Transition: Making Legal Recognition for Transgender People a Global Priority (Human Rights Watch, 2016). Malta, Ministry for Education and Employment, Trans, Gender-variant and Intersex Students in School Policy (2015). UN-Water, “Gender, water and sanitation: a policy brief” (2006), p. 4. United States Human Rights Network and others, submission to the Special Rapporteur.