The etymology of the term Queening Stool most likely emanates from the stool used a Queen or upper class lady when going to the toilet, before toilets were invented. The stool would be a sturdy four legged stool at least 20cm (8") tall and probably the same seating height as a normal chair. Although resembling a toilet seat the hole was likely of a smaller diameter. A commode or night cabinet is a similar piece of bedroom furniture of a later time, generally not requiring an assistant.

A servant would assist the Queen (or lady) to sit on the stool without entrapping her clothing. The lady would usually be wearing breachers, which are long legged underwear without a crotch, or with an open (unsewn) crotch. The servant would place a "chamber pot" under the stool to collect the ladies droppings. This is also the likely source of the term "stool" referring to feces.

After the Queen completed the call of nature, the servant would then remove the collection pot and clean the lady's nether regions. Kings and some upper class gentlemen were also serviced in this manner and a King's Stoolman was a highly respected and trusted position, having every opportunity to assassinate the king while "on the job".

In modern BDSM vernacular, the Queening Stool allows open access to the crotch while seated. The position allows the Pelvic floor muscles (PFM) to relax and therefore partly exposing the Labia minora to intimate touch. The Gluteus maximus, Levator ani and Puborectalis or Sphincter recti muscles, the major muscles of the crotch, can relax and sag allowing easy access the vagina and rectum.