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Health

Let’s Be Real: Americans Are Walking Around With Dirty Anuses

But is the brown tide finally turning?

Human solid waste doesn't seem like a great idea for a cafe, but the opening of Poop Cafe in Toronto late last year led to long lines and lots of media attention. The Koreatown spot serves desserts like patbingsu—shaved ice and red beans—in bowls that look like toilets, and personifications of the poop emoji can be found throughout. The desserts themselves don't look like poop but the decor of the spot, based on one the owner visited in Taiwan, doesn't seem to be turning anybody off all the same.

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Nonetheless, North America is a strange spot for Poop Cafe. Time and again, we have shown ourselves to be far more squeamish on the topic than our fellow poopers around the world. Exhibit A: We live in the dark ages of post-shit cleanup. In a wide world that has long embraced the effectiveness of anus-washing after doing number two, America hangs back, clutching our rolls of Charmin, despite plenty of evidence that it would serve us better to wash instead of wipe. We may be obsessed with sanitation, yet we insist, against reason, on the least-sanitary, least-healthy option for managing our poop.

Several bidet companies have tried to market their products in North America on a variety of different measures, from their technological impressiveness to the evidence of the health benefits they offer. But they have yet to overcome the significant hurdle that exists because North American consumers simply aren't used to considering the purchase of a toilet for any reason but an immediate need for one.

"The toilet in North America is not seen as an upgradable item in the home," says Rose George, author of The Big Necessity: The Unmentionable World of Human Waste and Why It Matters. "You only get a new toilet if you move or if your toilet breaks. There has been some change in the industry at marketing a toilet as a desirable, upgradable object rather than what is known as a 'distress purchase,' but it's slow-going."

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"Toilet paper moves shit, but it doesn't remove it. You wouldn't shower with a dry towel; why do you think that dry toilet paper cleans you?"

It's not easy to find statistics on the number of bidets in American homes, perhaps because they remain uncommon. About 22 percent of bathroom designers saw requests for bidets in 2015, according to research by the National Kitchen and Bath Association, but that group skews towards higher-end markets. Kohler has seen demand for its "intelligent toilets" grow 50 percent year over year for the past three years, but a study the company conducted last year found that 53 percent of Americans were still unwilling to use a bidet, says media representative Katie Dilyard.

Meanwhile, more than 90 percent of homes in Spain, Italy, and Greece have a bidet. And about 60 percent of Japanese households have high-tech washlet toilets with features like spraying and air drying, reports Justin Thomas of Metaefficient.com, and the country's cabinet office includes Toto-style washlets among the penetration rates it tracks for consumer goods.

"I find it rather baffling that millions of people are walking around with dirty anuses while thinking they are clean," George says. "Toilet paper moves shit, but it doesn't remove it. You wouldn't shower with a dry towel; why do you think that dry toilet paper cleans you?"

"I think we owe it to the English," says Harvey Molotoch, a New York University professor and author of Toilets: Public Restrooms and the Politics of Sharing. "So many of the conventions of American life come from the British."

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This particular convention, dating back to the 18th and 19th centuries, has a surprisingly tawdry origin considering the taboo that surrounds it today. "English men met up with bidets when they would go to Paris, often to live a libertine life," Molotoch says. In particular they associated bidets with brothels and prostitutes and in that way they took on an extra element of salaciousness.

Bidets were also suspected by some to be a form of birth control, Molotoch says, which added to the anxiety around the appliance. "It's associated with frivolity, weakness, immorality, femininity so therefore denigrated," he says. Those associations continue today: bidets were a punch line in the movie Get Him to the Greek and part of a joking Jennifer Lawrence video.

One luxury hotel in New York took a leap and installed bidets in the late 19th century, Molotoch says. The public reaction was strongly negative and the bidets eventually had to be torn out. "So in a way they learned their lesson and nobody tried it again for a good long time."

That lesson had a strong logistical component as well: The small size of many North American bathrooms made it difficult to accommodate both a regular toilet and a bidet, and plumbing in homes wasn't a simple thing to change once it was standardized for the non-bidet flush toilet.

"The more hurdles there are, the more you have to talk about these things," Molotoch says. "And given that these things are all sort of surrounded by taboo, then that further erodes the possibility of anything changing."

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Those taboos are seen in the very way that we market bathroom fixtures, toilets in particular. There's a reason that white has remained the standard color for toilets for decades even as other home decor trends shift considerably, Molotoch says. "There's a kind of implication that if things are white, then they are sanitary."

The health and sanitation benefits that companies have leaned on in marketing bidets in the United States are backed up by evidence. Regular bidet use has been shown to prevent hemorrhoids in those prone to them, says gastroenterologist Partha Nandi, and can offer relief to those who already have the condition. "It can be useful with patients who suffer with hemorrhoids since toilet paper can be quite irritating," Nandi says. "Hemorrhoids can be further aggravated due to the friction of toilet paper, so bidets offer a less harsh alternative."

Bidets have also been associated with reduced occurrence of urinary tract infections as well because they help remove the bacteria that can multiply at the opening of the urethra and travel up to the bladder, Nandi says. "While the use of toilet paper does not ensure cleanliness in the restroom, bidets can prevent UTIs by offering a refreshing and sanitary way to remove bacteria and ensure the spread of bacteria does not occur," he says.

Living among the squeamish in Canada and the US are people of Muslim and Hindu backgrounds who are the satisfied owners of far cleaner butts than the rest of us.

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Meanwhile, infectious diseases are commonly spread by direct person-to-person contact, according to the Mayo Clinic, and fecal matter is one agent of direct transmission. Research done by Michigan State University in 2013 found that only 5 percent of people wash their hands for long enough to destroy infectious germs after using the bathroom. If they have a bidet, at least something is getting washed properly—and there's less need for your hands to be near fecal matter at all.

It's also common sense that washing with water will remove more fecal residue and bacteria than simply wiping. "It has always baffled me," says George. "We wash every part of our body except the dirtiest part." She points out that we wash our cars with soap and water and buy special products to wash our pets but have a continued aversion to using water on one of the parts of our bodies that could really use it more often.

Living among the squeamish in Canada and the US are people of Muslim and Hindu backgrounds who are the satisfied owners of far cleaner butts than the rest of us. George wrote in her book about Muslim and Hindu customs around toilet cleanliness, which includes washing with water to cleanse the genitals.

"It's not easy to be a water user in a toilet-paper society, so Muslims and Hindus and other water-cleansing cultures have had to adapt," George says. For the most part they do this quietly—or example, bringing an empty soda bottle into the bathroom in public places, or keeping a plant in a shared apartment so you have an excuse to have a watering can around. These groups can't make their need known if they don't feel comfortable talking about it, and it's unlikely they'll feel comfortable talking about it if they're in a wider society that keeps quiet about what happens in the bathroom.

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"I admire coping strategies," George says, "but really, why are we ashamed?"

It seems our deeply ingrained ideas about sanitation and fears about appearing somehow unclean actually work against the adoption of the bidet. We have a lot of misplaced anxieties about how clean our bathrooms and toilets are, Molotoch says. "There is great fear of toilet seats as a sanitation issue and that's a false fear," he says. "The filthiest sponge in a house is the kitchen sponge." It can seem counterintuitive, even somehow deviant, to spend time and energy and money on something somehow luxurious for something we all see as dirty.

And unlike cleansing wipes we can put in our medicine cabinets or cans of Lysol that can be hidden under the sink, a bidet is out there for everyone who happens to be in our bathroom to see—or worse, perhaps ask about.

It seems our deeply ingrained ideas about sanitation and fears about appearing somehow unclean actually work against the adoption of the bidet.

"A bidet signals some secret dirtiness," Molotoch says. "You don't want to reveal to anyone that you have done anything that would require special measures of sanitation because you live such a clean life."

How did the polite-as-hell Japanese come to embrace their butt-cleaning technology so wholeheartedly? "Japanese people are very circumspect and do not speak of intimate things, but the Japanese are super straightforward about the toilet," Molotoch says.

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The process wasn't easy, George says, and took about 60 years. It was also helped along by cultural factors like the Japanese concept of wabi sabi, she says, a difficult-to-translate concept that centers around purity and cleanliness.

"Though this is of course generalizing, there is a prudishness in Japan which meant that a hands-free device that cleansed the body properly would eventually be popular," George says. "But it took decades of advertising, of installing bidet toilets in business hotels so that salarymen would go home and want one in their own house too."

Japan has also pushed much of the technological advancement around toilets and bidets. Features like heated seats, the option of warm or cool water for the bidet spray, and air drying are commonly found in Japanese washlet toilets. In North America, automatic-flush toilets are top of the line in technology, but it's not unusual for a toilet in Japan to have a dozen different buttons.

Japan has another leg up on the pursuit of cleaner asses: cute poop. Japanese children are taught very specifically how to clean themselves when they are being potty trained, Molotoch says. An element of adorableness is helpful when you're trying to teach something to young kids.

In the past couple years we all watched, mesmerized, as a unicorn shat rainbow soft-serve into a toilet courtesy of the folks at Squatty Potty.

Shit talk has, of course, also finally made it to North America. In the past couple years we all watched, mesmerized, as a unicorn shat rainbow soft-serve into a toilet courtesy of the folks at Squatty Potty. A fetching redhead with a proper English accent and a poufy dress defecated unapologetically in front of the camera in a spot about Poo-pourri (a product that nonetheless plays upon our squeamishness about the way our shit smells). And like in Japan, we are also embracing cute feces. Mr. Hankey the Christmas Poo, the star of the holiday episode for South Park, is equal parts gross and adorable. And the smiling poop emoji has of course made its way from being a funny thing to send in a text to a bonafide mascot: you can now buy phone cases covered in the little guy and a stuffed version to keep on your bed, among other items. A report on emoji use published by Swiftkey in 2015 found that bidet-averse Canadians are the smiling poop emoji's biggest global fans.

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"Things do change, and also they arise in the most unlikely places," Molotoch says.

We're also becoming more open to discussing defecation and fecal matter in a medical sense, even if it's usually in somewhat coded terms. Ads for probiotic yogurts talk about their ability to keep you regular. Major publications have written about the growing body of research on the benefits of fecal transplants. And food trends like gluten-free eating are in part fueled by an interest in preventing constipation and digestive distress.

"I think we have made great steps in legitimizing talking about guts and bowels, but I'm not sure yet that that has translated into hygiene change in our private bathrooms," George says.

The increasing availability of inexpensive bidet attachments might soon start moving us towards that hygiene change. George is a fan of her Washlet attachment. Writer David Sax spoke in glowing terms about the bidet attachment in his home in an article for GOOD. And Tushy is marketing its minimalist, easy-to-install bidets to design-conscious millennials.

"It's not this ugly geriatric old-person-looking thing that you're embarrassed about," says Tushy founder Miki Agrawal about her company's bidets. (Agrawal is also the founder of Thinx period-proof underwear.) "It's this beautiful designer product you're proud of." If your bidet is attractive and appealing-looking, the thinking goes, you're a lot less likely to be embarrassed about using it—and talking about it. "Hopefully affordable bidet attachments might lead the way to nations with cleaner butts," George says. "Honestly, I think once you start cleansing with water, you can't go back to dry toilet paper."

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