When Oprah Winfrey served on a Chicago jury in 2004, she couldn’t go to the bathroom attached to the jury room unless her fellow jurors sang to drown out the noise. One of the songs they sang was Kumbaya.
When Alexis Sanchez used the bathroom in her college dorm, she brought her iPod with her.
“I would blast it,” she says. “I would play 'D. A. N. C. E.' by Justice, and some Maroon 5 song. That was my poop playlist. It had to be a ritual or else I would focus too much on if there were other girls there who could hear or smell what was happening.”
Sanchez, now a 22-year-old front-end web developer for the Tampa Bay Times, has since abandoned her poop playlist, but is still incredibly anxious about using public bathrooms—for both numbers one and two. “It’s definitely a problem,” she says. “It affects my life.”
Many people, like Oprah and Alexis, suffer some degree of anxiety about going to the bathroom when others are present. Paruresis, or “pee-shyness” is classified as a social anxiety disorder in the DSM-V, the American Psychiatric Association's diagnostic guide. It’s a sort of performance anxiety, a fear of being scrutinized by others while you go.
According to Steve Soifer, chair of the University of Memphis department of social work, and CEO of the International Paruresis Association, about 20 million people in the U.S. suffer from paruresis to some degree (220 million worldwide). He notes, though, that it’s a spectrum. Whereas some people are just mildly uncomfortable, some suffer so extremely that they physically can’t go in the presence of others. Some paruretics have to resort to self-catherization (inserting a tube up your urethra and into your bladder) if they’re in a place where they can’t avoid using a public bathroom.
“In its extreme form, people become agoraphobic,” Soifer says. “I know people who’ve never dated, never gotten married. I know one guy who had a master’s degree and ran a paper route in the evening, so he knew exactly where a safe bathroom was [if he had to go at work].”
The IPA has a term for “poop-shyness” as well: parcopresis. But this isn’t a medically recognized condition, and is less of an issue for most people, according to Soifer. The relative infrequency of bowel movements means people can usually time them for when they’re in a bathroom that makes them comfortable. In rare cases, like dorm bathrooms, people like Sanchez may not have that option.
Soifer doesn’t deal much with parcopresis—he says he’s rarely seen someone who has both it and paruresis. “People call me Dr. Pee, and I tell them I don’t want to be Dr. Poop as well,” he says. “It’s too much.”
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Even for the rest of us, who don’t suffer a clinical level of anxiety, the public bathroom is a place that has ingrained behaviors and social rituals—leaving space at the urinals, avoiding conversation even with people you know—that we’ve all experienced, if not daily at an office, than out in the world, at restaurants and ball parks and airports. The public collides uncomfortably with the private in the bathroom as it does nowhere else, and the unique behaviors we perform stem from a complex psychological stew of shame, self-awareness, design, and gender roles. If you boiled this stew down, though, it’d come down to boundaries—the stalls and dividers that physically separate us, and the social boundaries we create with our behavior when those don’t feel like enough.
In an increasingly sex-positive culture, it seems like bathroom issues are the last thing most people are reluctant to talk about. Serious attempts to research bathroom behavior or design have been done by just a few people who have been willing to break the taboo. One of these, Nick Haslam, author of Psychology in the Bathroom, explains that we attach “shame and secrecy” to the bathroom from a very early age, and that some of that is evolutionary.
“Part of that is surely due to the fact that we are socialized from an early age to control excretion and taught that failures of control are embarrassing and humiliating,” he told me via email. “And from an early age we learn that excretion is something you do on your own, behind closed doors…Another reason for the taboo is perhaps an entirely adaptive and evolved aversion to bodily waste, which is linked to disease and contamination. To some degree there will always be some anxiety and disgust attached to excretion for this reason.”
But he also notes that talking about bathroom issues wasn’t always this taboo. If we’ve talked about it before, we can talk about it again, and in talking, maybe find ways to ease some of the anxieties people feel in public bathrooms, and reduce the need for us to be so vigilant about policing our behavior.
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Until the 1800's, there was little expectation of privacy while using the bathroom. Economic prosperity and religious notions of modesty made the desire for a private space in which to do one’s business more widespread. Today, most people living in developed countries expect privacy in the bathroom. Paradoxically, most bathrooms outside of private homes are designed for multiple, simultaneous occupants.
In his 1976 book, The Bathroom, Alexander Kira wrote: “Most of our feelings about the body, sex, elimination, privacy, and cleanliness are magnified in this context of ‘publicness,’ for the fact of publicness, with its inevitable territorial violations and loss of privacy, increases our apprehensions.”
The blurred line between public and private was made manifest in Italian artist Monica Bonvicini’s 2003 sculpture "Don’t Miss a Sec"—a usable public toilet encased in one-way glass installed outside London’s Tate Britain gallery. Passersby could not see in, but the person using the toilet could see out.
Kira explains that the two kinds of privacy we desire are “privacy for” and “privacy from.” We want privacy for our own elimination, and privacy from other people doing theirs.
“Toilet activities are highly personal and ordinarily occur backstage of life,” says Harvey Molotch, a professor of sociology and metropolitan studies at New York University and co-editor of Toilet: Public Restrooms and the Politics of Sharing. “You have this really harsh tension between the public and the private, which I don’t think exists anywhere else. That’s troublesome, it has to be settled in some way.”
How it’s usually settled in the U.S. is with metal partitions, which Molotch says are “just made with the flimsiest crap.” This is just for stalls of course—men’s urinals typically have even less substantial partitions, if indeed they are divided at all. Obviously, these physical boundaries, though they may protect you from being seen (or may not, entirely, if there are gaps in the stall door), do not protect you from being heard, or smelled.
Because these physical boundaries alone are, for most of us, insufficient, we have to reinforce them with our behavior. A 1985 study called “Meanwhile Backstage: Public Bathrooms and the Interaction Order” notes that “it is not physical boundaries, per se, that define a space as a stall but the behavioral regard given such boundaries.”
This is why conversation usually ceases once you enter a stall (and if you do dare to talk, it’s normally to a friend, not a stranger), why we say “Sorry” and quickly retreat if we accidentally open an occupied stall, why we politely ignore any sounds or smells that emanate from nearby stalls—because we want others to do the same for us. These are generally understood behavioral guidelines, but the situation is very different in men’s and women’s bathrooms.
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Biologically speaking, men and women don’t need separate bathrooms—they’re using them for the same reasons. While there are a few functional differences—many men prefer to pee standing, women need receptacles to throw away tampons and pads—it’s not hard to imagine a unisex bathroom that would, at least in theory, work for everyone. In reality, an ingrained sense of modesty about concealing our bodies from the opposite sex might prevent such a bathroom’s success, but many single-user public bathrooms are already unisex. As prominent sociologist Erving Goffman noted in his 1977 essay The Arrangement Between the Sexes, “the functioning of sex-differentiated organs is involved, but there is nothing in this functioning that biologically recommends segregation; that arrangement is totally a cultural matter.”
This culturally agreed-upon separation creates unique single-sex spaces. There is perhaps no other arena that so stridently reinforces gender separation and difference.
“Public toilets…frequently instantiate the most literal and entrenched social division—the division of people into two unchanging sexes,” writes Ruth Barcan, senior lecturer in the department of gender and cultural studies at the University of Sydney, in her chapter for Toilet. “This form of segregation is at once immensely naturalized and immensely policed, the most taken-for-granted social categorization and the most fiercely regulated.”
The nature of these single-sex spaces affects men’s and women’s attitudes toward using the bathroom, as well as their behavior in them.
The arrangement works out in women’s favor, according to Sarah Moore, a senior lecturer at the Royal Holloway University of London’s Centre for Criminology and Sociology. In the bathroom, people are free of the typical gender hierarchy of the co-ed public sphere—in which men are at the top.
“This shines a light on what it means for men and women to be exclusively in the company of their own sex,” Moore told me in an email. “For women this is often liberating; for men it’s often anxiety-inducing.”
In a study published in the British Journal of Criminology in 2012, Moore, along with Simon Breeze, observed 20 public toilets in London and Bristol, and interviewed the men and women who used them. She found that though both sexes had plenty of complaints, women’s were more about the cleanliness and quality of the facilities than anxiety about other occupants. They were more relaxed and social overall, chatting with strangers in line, watching doors for each other, sharing makeup.
Men, on the other hand, were on edge. Moore goes so far in the study as to say that for men, public toilets are “nightmarish spaces.” The anxiety they reported was centered around “watching”—being watched by other men, or being perceived to be watching other men—and that this watching was linked to the possibility of sexual violence.
The theory Moore lays out is that, in public, the gender hierarchy makes women the ones who are watched (under the “male gaze,” as it were). But in the bathroom, sans women, men worry about being the object of another man’s gaze, a feeling they don’t often confront in other places. This can make them fearful, even if there’s no real threat present.
“Many of the men we interviewed felt that they’d experienced implied violence (things like odd and overly-long looks that they felt to portend sexual violence),” Moore says. “This could just be a perception of course. Once we start feeling unsure of a space, we’re perhaps more likely to read danger into a situation that was actually perfectly fine. Here’s what I think: The threat of sexual violence in men’s public bathrooms is actually minimal; it’s the nature of that threat—not just to men’s safety, but to their sense of masculinity—that prompts feelings of anxiety.”
And from this anxiety is born the famous urinal rule.
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It is well-known, even among women who have never had occasion to use a urinal, that it is expected that men not use a urinal directly next to someone else. (Some women I’ve spoken with have said they prefer to have an empty stall as a buffer between themselves and others also, but it is a much stronger norm in men’s bathrooms.)
The vulnerability and exposure of using a urinal seems to create the need for additional social boundaries, in place of even “flimsy” physical ones. A famous, though ethically questionable, study from 1976 found that invading this socially agreed-upon bubble of personal space made it much more difficult for men to pee. To discover this, one researcher hid in a bathroom stall and watched men at the urinals through a periscope, timing the “delay and persistence” of urination when a confederate came into the bathroom and stood right next to or one urinal removed from the unknowing participant. The closer the confederate was, the longer the delay before the man was able to go, and the less time he peed overall. Whether he would have been able to go at all had he known someone was spying on him through a periscope, no one can say.
The Goffman-coined term “civil inattention” is the scientific way to describe how men often treat each other at the urinal, and how people treat strangers in the bathroom generally. While one person might acknowledge another with a glance, he then immediately withdraws his attention. As the 1985 study put it, “through this brief pattern of visual interaction, individuals both acknowledge one another’s presence and, immediately thereafter, one another’s right to be let alone.” When forced through circumstance to use adjacent urinals, this civil inattention gets bumped up to what the study calls “nonperson treatment,” in which someone simply treats his neighbor as if he does not exist.
Existentialist philosopher Jean-Paul Sartre, in his book Being and Nothingness, wrote about the self-consciousness that can arise when one feels like one is being watched: “What I apprehend immediately when I hear the branches crackling behind me is not that there is someone there; it is that I am vulnerable, that I have a body which can be hurt….in short, that I am seen.”
In the bathroom, feeling that you are seen can leave you too self-conscious to go. A social contract not to look at one another, to treat each other as objects, may help alleviate that. As Moore writes in her study, “Toilet etiquette requires that one adopts an attitude that very closely resembles that of the perfectly alone individual in Sartre’s writing.”
The urinal rule and its obsession with not-looking may be a behavioral boundary designed to enhance bathroom-goers comfort and sense of privacy, but it also smacks of homophobia, especially when you consider Moore’s finding that many men worry about sexual violence in the bathroom. Nolan Feeney, a former colleague of mine, expressed discomfort with the connotations of the urinal rule.
“What is the implication here?” he asked. “That guys aren’t going to respect each other’s privacy? That proximity leads people to take a sneak peek? Some people are pee-shy, and that is totally understandable, but the take-away of the informal rule of urinal space often isn’t that some dudes like their space, it’s that some dudes—particularly queer dudes—can’t be trusted.”
Moore says some of the answers she got in her study were homophobic, but that it was generally not because they feared other gay men but because the men themselves wanted to “reinforce that they weren’t gay.”
Molotch adds that “homophobia is certainly playing a role, and helps to make it very tense.”
Public bathrooms are also often fraught with tension for transgender people, who, if they want to use the bathroom designated for their true gender, may be bullied or derided for doing so. But using the bathroom of their birth gender is similarly stressful. A school in Thailand solved this problem by offering students a “transsexual toilet,” and gender-neutral bathrooms are becoming increasingly common as a way of addressing this issue—even mandated by law for all new or renovated buildings in Philadelphia.
Single-person restrooms are another option to ease bathroom tension, for the LGBT community as well as for paruretics, for whom social rituals are not enough to ease their anxiety.
“Nothing gives me more happiness when I walk into a place and they only have a single stall bathroom,” Sanchez says. “There’s no stress, I can just relax. It’s like a spa.”
* * *
Sanchez first had to face her fear of pooping in public when she attended a summer program at a Philadelphia college in high school, and had no choice but to use the standard dorm bathroom.
“I was forced to poop while other girls were showering,” she says. “Probably for four days I just refused to poop, which is obviously unhealthy. And I was apparently not the only one. Some other girl on my program got sent to the hospital because she went seven days without releasing the contents of her colon.”
This is why she developed her iPod strategy, which she carried into college. She says this traumatizing experience left her anxious about peeing in public bathrooms too, whereas before she’d been okay with it.
Now, in the workplace, she has new strategies.
“I walk in, I immediately scan every door,” she says. “I take in the situation and if there’s nobody in there, I start running. I sit down and am immediately yelling at myself ‘Go, go, go, you can do it, goooooo!”
But if someone comes in before she’s able to pee, it’s over.
“I call it my failure to launch,” she says. In that case she’ll either wait for the person to leave, or pretend that she’s already finished, flush, wash her hands, and leave.
Soifer has seen similar strategies among paruretics he’s worked with. “There’s all sorts of routines, we’ve all developed them,” he says. “One of the classics is, if you walk in after someone, you wash your hands until they leave.”
Soifer runs weekend-long workshops for paruretics, using a “pee-buddy” system to ease them into being comfortable going with someone else nearby. Over the course of the weekend, their assigned partner will get nearer and nearer to them as they go, and the weekend often ends in a trip to a highly-trafficked public bathroom, such as one at a baseball park. This desensitization can help immensely.
“My mom always joked, ‘You’ll get over these bathroom anxieties when you get pregnant,’” Sanchez says. “'You won’t care that people are listening to you, because you’ll have to pee that badly.’” So far, she says that her bathroom anxiety was at its lowest when she had an internship at a magazine that offered free tea in its kitchenette. “I was drinking so much tea, and I had to go to the bathroom so often, and it was so urgent that I didn’t care.”
Though, depending on the extremeness of someone’s paruresis, they may never be comfortable using a public bathroom, design can help. A frequent complaint I’ve heard (not just from paruretics) is that American stall doors don’t reach from floor to ceiling, as many European ones do. According to Soifer, more substantial urinal dividers help immensely as well.
“My favorite public restrooms to go to are movie theaters, bars, and really loud restaurants,” Sanchez says. “At the movie theater there’s always, like, 1000 people in the bathroom, so nobody knows which stream is my stream. At bars they always have music playing, so that sort of cancels out my stream.”
Japan has found an innovative way to deal with the noise issue, in the form of a device called the Otohime or “Sound Princess.” It plays the sound of a flushing toilet, to mask whatever sounds a person may be making, as an alternative to the apparently popular practice of flushing the toilet constantly to hide one’s sounds. The Sound Princess is installed on the wall in some Japanese bathrooms (mostly women’s) and there is also a portable version available for purchase.
Unfortunately, Molotch says, despite the positive effects design can have on people’s comfort level in the bathroom, it’s rarely given much thought.
“I’ve been on a lot of building committees for major university buildings, and the thing that is least talked about is the public restroom,” he says. “If someone were to bring it up, it would cause giggles…In architecture firms, the lowest-ranking person designs the bathroom.”
This unwillingness to seriously discuss public restroom design can stifle innovation, and leads to the relatively homogenous bathrooms we see in most buildings, which, Molotch says, “looks like all the same stuff from Staples.” And as we’ve seen, many aspects of the generic American public bathroom can exacerbate people’s anxieties.
Barbara Penner, a senior lecturer in architectural history at University College London contributed an essay to the Molotch-edited Toilet describing how the bathroom taboo has blunted scholarly work as well.
“The refusal to deal openly with the realities of toilet use can have calculable and devastating impacts on local ecosystems, health, and living standards in developing countries,” Penner writes. “But…we in the so-called civilized countries suffer from this blinkered approach as well.”
* * *
Despite our evolution as civilized humans who can send spaceships to Mars and contemplate the nature of our own existence, we all still have to shit. And yet, it’s something nearly everyone is ashamed of and disgusted by. The popular Japanese children’s book, “Everyone Poops” (which caught on in the U.S. despite this taboo) offers an equalizing message to kids newly using the toilet. But this message doesn’t seem to be something we internalize as adults. This is because, as Haslam writes in his book, “defecation and urination… are processes that remind us of our animality and our vulnerability to death and decay.”
“At least according to one psychological theory (a theory called "terror management") people feel threatened by reminders of their own mortality,” Haslam says. “In theory, at least, signs of our "creatureliness" (essentially how we are similar to other animals) remind us of our mortality and to defend ourselves against this realization we invest in being cultured and civilized (i.e., our uniquely human attributes).”
Bathroom boundaries also help us keep these creaturely processes separate from our public selves. That’s not to say such measures are sufficient to save us from embarrassment. Though others may ignore what’s happening in our stall, we know that they know and they know that we know that they know, etc. To apologize, “the offending individual may offer a subtle self-derogatory display as a defensive, face-saving measure,” the 1985 study reads, such as making a disgusted face, or even a self-deprecating joke, if you know the other bathroom occupants.
“Through such subtle self-derogation, offending individuals metaphorically split themselves into two parts: a sacred self that assigns blame and a blame-worthy animal self,” the study says.
We re-sacralize our bodies (and, you know, protect from germs) after these “dirty” acts by washing our hands, and harshly judge those who don’t. Even though, in a 2013 survey, 70 percent of Americans admitted they just rinse their hands without using soap. The expectations for our “sacred selves” may here be somewhat divorced from reality.
Even the word “bathroom” is a sanitizing term. No one is actually bathing in public bathrooms. (Well, maybe at rest stops on cross-country Greyhound bus rides.) “Restroom” is another term that refuses to describe the thing it refers to. (My dad has taken to humorously saying he needs to “go rest” whenever he goes to the bathroom.) Same with “powder room,” “water closet,” “can,” “loo,” and “little boys’/girls’ room.” Perhaps the only nickname for the bathroom that actually refers to its function is “crapper.” (Which also refers to the plumber Thomas Crapper, who helped popularize the flush toilet.) And Leslie Knope of Parks and Recreation’s preferred term, “whiz palace.” Neither of which you would (probably) say to your boss, or in any situation in which you’re hoping to be taken seriously. It’s unbecoming, unprofessional to acknowledge what you do in the bathroom, even if everyone else is doing it too.
Engaging with our animal selves means dropping our public face, which we must then put back on when we leave the stall. So we check ourselves in the mirror before leaving the bathroom. It seems this appearance check almost always happens on the way out of the bathroom, never on the way in. It’s a chance to reset, before returning to a place where the public is only public, not colliding with the private in awkward uncomfortable ways. Molotch notes that men are less comfortable performing this check openly, and the lack of opportunity to “recover” their public faces may contribute to bathroom anxiety.
“Men are not supposed to care how they look cosmetically, so a man has to walk past the mirror and adjust his hair or collar without calling attention to the fact that he’s doing that,” he says. “It’s very funny. It’s a very specific choreography they do. They’re walking out of the bathroom, the mirrors are there, and without breaking pace, they catch a glimpse of themselves and move their hand up to their hair to adjust it.”
The 1985 study explains that the bathroom is the ideal place for these adjustments to our appearance because, while still semi-public, is considered “backstage” of life. Adjusting our hair or makeup at a restaurant table, for example, would divert our attention from what’s happening around us—we want our public face to be poised and ready.
“Much of what we do in public bathrooms, then, is what we must not do elsewhere but what we must do somewhere,” the study reads.
Indeed, though the bathroom’s unique nature can be anxiety-inducing, the behavioral regard given to the space, and its emphasis on privacy, can also make it a safe place to drop our public personas and do vulnerable things like fix our faces. Or cry.
Once you’ve laid claim to a bathroom stall, others typically respect that claim, using all of the behavioral rituals outlined above. This transforms the stall into “the occupying individual’s private, albeit temporary, retreat from the demands of public life,” according to the study. This makes the bathroom feel like the safest place to cry, or work through other emotions one doesn’t want on display, when there isn’t the option to go home.
Public bathrooms can be places of comfort or unease, places where women can relax, where men feel fearful, or where those outside the gender binary feel judged and uncomfortable. But all the social rituals and face-saving strategies are often so much duct tape over a hole we could more effectively patch if we were willing to talk about the bathroom long enough to innovate.
“The bottom line is we’re a puritanical society,” Soifer says of the U.S. “We still have these standards that are almost unconscious I think.”
“How does one redesign a taboo?” Penner asks in her essay. “The question remains pertinent, as toilet taboos have proved remarkably resilient in the face of change—the final frontier of taboos, now that sex is no longer unspeakable in public.”
Soifer draws a similar comparison—he claims he tried to get on Oprah’s show once to talk about paruresis and was denied. “And Oprah will talk about anything,” he says. “Look at how we talk about sex as a society, and we can’t talk about bathroom problems? It’s kind of out of whack if you ask me.”