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.

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.

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.

"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?"

"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."

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.

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.

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."

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 .

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.

"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."

"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?"

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."

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.

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.