Open defecation is a major global health problem. The number of open defecators in India dwarfs that of other states, and most live in rural places. Open defecation is often approached as a problem scaled at the site of the individual, who makes a choice not to build and/or use a toilet. Attempts to end rural open defecation by targeting individuals, like social marketing or behavior change approaches, often ignore the structural inequalities that shape rural residents’ everyday lives.