Objective: This study examined cisgender and transgender and gender diverse (TGD) college students' perceptions of gender-neutral bathroom availability across eight U.S. campuses, TGD students' fear of harassment related to (lack of) availability of gender-neutral bathrooms, and the relation between fear of harassment and TGD students' psychological distress. Methods: Participants were 4,328 college students (4,195 cisgender, 30 binary transgender, 103 gender diverse) from eight U.S. institutions of higher education. Results: The majority (84.2%) of TGD students and 34.6% of cisgender students perceived there were too few gender-neutral bathrooms on their campus. Further, TGD students' fear of harassment related to a lack of availability of gender-neutral bathrooms on campus was positively associated with psychological distress (i.e., symptoms of depression and anxiety). Conclusion: This study highlights the significance of increasing accessibility of gender-neutral bathrooms on campuses to help mitigate TGD students' fear of harassment and psychological distress.