Intro & Methods
Results, Part 1: People Taking Cover
Results, Part 2: The Women (and Men) Who Hover
Discussion & Acknowledgments
Supplemental Data: Selected Excerpts from Focus Group Discussion

“Okay… welp, sometimes science is more art than science, Morty. A lot of people don’t get that.”
—Rick Sanchez, Rick and Morty


Despite there being virtually no evidence that public toilet seats can transmit any sort of disease or infection, many people are in the habit of avoiding skin contact with these shared porcelain platforms. We conducted a focus group discussion and developed an online survey to evaluate current practices and perceptions pertaining to preventing proximity to public potties. The vast majority of our study participants were highly-educated young professionals, and of these respondents, over 70% reported either using a seat cover or hovering with some regularity. The frequency with which respondents engage in these barrier-maintaining exercises is drastically reduced in the setting of a private home or hotel room. While the practice patterns of covering versus hovering differ between male and female respondents, it appears that regardless of gender, the large majority of well-educated millennials cling fervently to an illogical antipathy toward contacting a public toilet seat. This study provides novel insight into the preparatory rituals that occur behind the closed doors of our public restrooms.


The first historic record of a flushing toilet actually predates modern plumbing. Sir John Harrington of England, a visionary who decided that pooping a in ditch was not for royalty, installed the first model for Queen Elizabeth I in the late 16th century. Centuries later with the birth of the industrial revolution, another Englishman by the name of Alexander Cumming secured the first patent for the flushable toilet in 1775. However, still another century would have to go by before finally the great Thomas Crapper (yes, his God-given name) secured Britain’s status as the world leader in lavatory innovation by helping to manufacture and popularize his own line of bowel bowls.

Some would say the rest is history. But I don’t say that. Somewhere along the way, we began taking for granted the proud porcelain that Sir Harrington originally designated for kings and queens. The success and subsequent ubiquity of the modern toilet perhaps made it seem a bit plebian while its indispensable function made its discussion faux pas. As these modern marvels of plumbing began being shared in public spaces, people began to fear cooties, and despite the youthful promises of circle-circle-dot-dot, Cornelius J. Dykstra went on to patent the modern toilet seat cover in 1922.

Today, toilet seat covers can be found stuffed in the structural orifices of public restrooms across the country, contributing significantly to a multi-billion dollar bathroom paper industry. Yet, despite the public panic over polluted porcelain, there is no biomedical or public health evidence that seat covers serve even the slightest function. In fact, there is virtually no evidence that a healthy human being risks contracting any type of transmissible disease from a toilet seat. HuffPo and FiveThirtyEight have already scooped this, and my own literature search suggests that the most dangerous part of the public toilet is not the shared seat, but rather the forceful flush causing infectious particles to aerosolize, a concept termed “toilet plume” by this brilliant review article in the American Journal of Infection Control.

Clearly, toilet seat covers are little more than astronomical wastes of time and commodity, at best—at worst, they serve as a capitalistic conspiracy to indoctrinate the masses with germaphobic anxieties. A recently conducted focus group discussion among six male participants indicated a wide range of beliefs and practices in regards to utilizing open-access toilets (see Supplemental Data). In light of this, we decided to conduct a broader survey to better understand the public’s deeply entrenched terror of contacting the public toilet seat.


WhatsApp messaging application was used to conduct a preliminary focus group discussion among 6 male participants known by the author for their outstanding thoughtfulness on related matters (see Supplemental Data). Based off this initial discussion, survey questions were created while working a particularly monotonous weekend shift. Using Google Forms, these survey questions were then disseminated by texting, emailing, and generally harassing a network of friends and coworkers. The survey can be accessed here and consists of 14 questions (6 of which are required), plus 5 additional demographic questions. The survey remains open for all who are still interested in participating.


NEXT SECTION: Results, Part 1- People Taking Cover

Posted by:jayzmd

Full-time resident surgeon and part-time tolerable millennial

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