Communal bathing and spas have been around for thousands of years, but the concept of modesty is a relatively recent one for Western culture. Many indigenous people would play sports without any covering, and athletes in ancient Greece also competed naked. In fact, the Greek word gymnasium means “a school for naked exercise.”Taboos against nakedness grew in Europe in the 18th century. Women began to wear more layers of clothing and protected their modesty and avoided the gaze of men at the beach by entering the water through elaborate bathing machines. In the United States, bathing suits were exceedingly modest until the bikini arrived after World War II.But certain aspects of the tradition of naked competition still existed when I was a young man growing up in Chicago in the early 1960’s. One of my worst experiences was being forced to swim in the nude in high school. This was a common practice in Chicago and other large city schools until the 1970’s. You had a choice: either swim in the nude for four years of high school or take ROTC to get a waiver. Envision 30 young boys at various stages of puberty, with a wide variety of body shapes, lining up so the coach, in his well-fitted swimsuit, could take attendance. There was my dramatically overweight friend with his eyes staring straight at the ground and my other friend, a “late bloomer,” just waiting for the inevitable insults about his manhood. There was also the constant anxiety that a pubescent erection could appear at any time. You could only hope that you were already in the pool when it struck. The reasons for this barbaric and hurtful practice were ill-founded—the need for hygiene, the fear of bathing suit threads clogging the pool or the desire to “build cohesion” between young men. Talk to any man raised at that time and you will get similar stories of shame and embarrassment.After physical education we took mandatory showers, our names methodically checked off a list by the now fully-clothed coach. I always looked for a place in the corner of the shower and tried to keep my towel close at hand. Schools and many athletic facilities for men still have communal showers, no stalls.I was already in medical school when I took my military entrance physical for the doctor draft. It was high school all over again. Grown men of different shapes and sizes, lined up to be poked and prodded. No one ever forgets being told to “bend over and grab your ankles.” With the increasing number of women in the military, I decided to research the current military physical exam. The article contains a section, “For Women Only,” where it proudly states that, “your visit with the physician will be in a private room.” Not so for the men, apparently. Six paragraphs down under a section titled “Do”, it says “Wear normal underwear. You will be sorry if you don’t!” Once again, a man’s modesty is a joke.Many men don’t speak up about their desire for privacy in fear that they will be mocked for not being “man enough.” In Texas we ask young men to “cowboy up.” There is the assumption that men bond by swimming or showering together in the nude, but I can assure you that, given a choice, we would have rather worn a bathing suit and showered in a stall. Locker rooms and the military are obvious examples, but let’s not forget the doctor’s office. In medical school men are instructed on how to examine female patients and respect their modesty. I must admit that for many years I never instructed a medical student on the need have a similar concern for men.
Over the years I’ve practiced medicine, I learned several things about male modesty that I don’t ever remember being told during my training. Many men don’t like being watched while they undress. I leave the room while they change, and offer them the same gowns I would a female patient, rather than assuming they are comfortable sitting around in their underwear. Gynecomastia (growth of male breast tissue) is common in all men. We generally think of it as a phenomenon of aging, but a surprising 65 percent of adolescents have it to some degree. Many men do not feel comfortable taking off their shirt to get into a hot tub or swimming pool, and, just like women, they may also feel uncomfortable sitting on the examination table without a shirt or gown. What’s more, a digital rectal exam can be just as unnerving to a man as a pelvic examination can be for a woman.
I like to talk with my doctor with my clothes on but, in the name of efficiency, I am often asked to undress and wait. We talk, he in his white coat and me in my Jockeys. The playing field is not level. Our culture tells men to “man up”, but the doctor’s office is one place you shouldn’t have to.