Background: Although recent quantitative research suggests that medical students are reluctant to engage in peer physical examination (PPE) of intimate body regions, we do not know why. Aim: This article explores first-year medical students' anxieties about PPE of intimate body regions at six schools. Methods: Using the Examining Fellow Students (EFS) questionnaire, we collected qualitative data from students in five countries (UK; Australia; New Zealand; Japan; Hong Kong) between 2005 and 2007. Results: Our framework analysis of 617 (78.7) students' qualitative comments yielded three themes: present and future benefits of PPE; possible barriers to PPE; and student stipulations for successful PPE. This article focuses on several sub-themes relating to students' anxieties about PPE of intimate body regions and their associated sexual, gender, cultural and religious concerns. By exploring students' euphemisms about intimate areas, our findings reveal further insights into the relationship between students' anxieties, gender and culture. Conclusion: First-year students are anxious about examining intimate body regions, so a staged approach starting with manikins is recommended. Further qualitative research is needed employing interviews to explore in depth students' anxieties about examinations of intimate body regions and how their views are shaped by interactions with peers, patients and doctors.