It's something that depends strongly on local culture.
In any one school, you are likley to find the phrase used has evolved to some short code format.
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Yes, "May I go out" sounds odd to me as it does not state the prupose, but asks for general permission to leave.
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I have not been in school for some time, so not sure what is used now.
Also, it might not be phrased as a question, but more as a statement, that gets acknowledgement.
What age?
I need to go to the bathroom.
I need to make a comfort stop.
May I be excused to go to the bathroom.
Could I be excused to go to the bathroom.
I have an urgent need to visit the bathroom.
I need to take a bathroom break.