Sex and the Citadel (14 page)

On the Saturday morning I visited, the place was packed, money flying in and out of a drawer in a small cash desk in the corner. Young, old, rich, poor—they all come here: a twentysomething in a neat hijab asking for lemon oil shampoo; a middle-aged lady, her frazzled hair uncovered, looking for
mughat
, a root that stops postpartum bleeding; and an obviously affluent silver-haired man in a safari vest asking for “ah … the usual thing.” Muhammad, the manager, smiled, wiped his hands on his jeans, and handed the man his order.

The “usual thing,” it turns out, is help for sexual dysfunction. Muhammad gets up to twenty people a day coming in for assistance. He’s worked in the shop for fourteen years, and the numbers looking for relief in sexual matters have risen, he says, men and women, young and old. And not just from Egypt either; the company gets orders from the Gulf as well, thanks to TV advertising.

“May God help you,” Muhammad said to the man departing with his usual. Muhammad sees his job as spiritual as well as physical: “If God gave somebody knowledge and he kept it from people, God will punish him for that.” In Muhammad’s opinion, there’s nothing strange or sacrilegious about invoking a higher power when helping people with their sex lives, provided they meet certain criteria. Women who come in for
gamagim
(an abortifacient made from animal skulls that looks like dried truffle chips) have to bring their husbands or guardians or show a doctor’s prescription. And he asks those looking for sexual stimulants if they are truly married, though for grooms-to-be he makes an exception. In any case, Muhammad practices tiered pricing: the more devout you are, or at least appear to be, the less you pay, so
munaqqabat
—women who veil their faces—are in luck.

With a university degree in commerce, Muhammad is an educated man, and he knows his history. The shop’s recipes are inspired by
Medicine of the Prophet
. This book, written in the fourteenth century by the Syrian theologian Ibn Qayyim al-Jawziyah, is Islam’s premier guide to wellness, combining injunctions from the Qur’an and hadith with medical advice to promote both physical and spiritual health.
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On the sexual front, the House has two popular
prescriptions. One consists of
gilingan
(galangal, a rhizome), along with dried alfalfa, arugula, and a few other ingredients to boost male performance. According to Muhammad, the advent of Viagra has made this item even more popular because “the chemicals in Viagra, if you use for ten years, it is too much. All Egyptians know this, which is why they come here because this you can use every day.” The second recipe combines palm tree and flower pollen (for energy), ginseng, ginger, cinnamon, and white pepper (to heat up the blood) and can be used by both men and women, one teaspoon twice a day.

Muhammad offered to prepare the latter for me, and darted about the shop, opening drawers and climbing ladders, throwing in a scoop of brown powder here, a pinch of green powder there, and a dash of some yellow stuff. He then added the whole mixture to a pot of honey. Honey is key to most of these recipes for reasons clearly stated in the Qur’an, in a chapter called “The Bee”: “From their bellies comes a drink of different colors in which there is healing for people. There truly is a sign in this for those who think.”
⁹⁰
Some forms of honey, like that from Yemen, are considered aphrodisiacal in their own right and are popular wedding gifts in the Gulf.

While Muhammad recited verses of the Qur’an, he stirred this concoction into a thick, gooey paste. He pulled a tiny amount away from the jar, like taffy, and offered me some with clear instructions: I had to say
bismillah
(in the name of God) before taking it. So I did, and it tasted like sweet, spicy halva. “God gives some people certain knowledge. This is built on the fact that if you pray to God, he will respond to you and you will get the cure through somebody like myself,” he explained. That may well be, but I doubt I have the stomach to take a spoonful of this stuff twice a day. No problem, though: Muhammad offers his customers a money-back guarantee.

MEANS OF REPRODUCTION

Impotence is just one of many reasons a married couple may fail to launch—that is, produce a baby by their first wedding anniversary.
While there is a trend among educated, professional couples to put off having their first child for a couple of years after marriage, the majority of Egyptians try to have a baby immediately; less than 1 percent of married women use birth control before their first pregnancy.
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A mere month after my wedding, several Egyptian friends asked whether I was expecting. Aside from the fact that Egyptians generally adore children, such solicitude is also pragmatic; many women will tell you that having a child—two to three is now considered optimal by young couples—is important for keeping a husband from taking another wife.
⁹²
As my grandmother used to say, “Clip your bird or it will fly the coop.”

Roughly one in eight Egyptian couples is infertile, on par with the global average.
⁹³
Yet in Egypt, as in most of the Arab world, when couples run into problems conceiving, suspicion almost always falls on wives. And so it was that Iman, our lady of the lurid lingerie, was sitting on my sofa, shyly examining a vibrating cock ring. A year into marriage, Iman was still not pregnant—a rising source of concern for the whole family. She was hoping a little more excitement in the bedroom might make intercourse more productive. Iman had already consulted a number of doctors, who immediately put her on fertility treatment, contrary to best medical practice, given that she’s still in her twenties and that the new couple was just warming up. Iman had been pricked, probed, and pumped up with hormones before anyone thought to check out her husband.

Siring a child is important to men in Egyptian society, and chinks in the armor of fertility are hard to admit. “When I started here eight years ago, I could not have imagined how much male factor infertility there is,” says Amira Badr al-Din Mehany, head of the embryo lab at the assisted reproduction unit of Al-Azhar University. Al-Azhar is one of the world’s oldest universities, established in the tenth century, and is associated with the famous mosque of the same name; on its doorstep is Khan al-Khalili, Cairo’s famous souk. Outside the university gates are winding alleys and shaded caravansaries, where from tiny stalls wares have been peddled for more than a millennium. Step inside the unit’s surgical wing, however,
and you hurtle through the centuries to the cutting edge of fertility treatment.

Gowned and gloved, Mehany and I were talking through surgical masks in a sterile lab, looking through a window at an operating theater, where a surgeon was extracting eggs from a patient. We watched as tubes of straw-colored fluid were passed through a hatch into the lab, decanted into a petri dish, and whipped under a microscope. A technician peered down its lens and rattled off numbers. “Three here,” she shouted. “Five more here,” she announced, counting eggs in the harvest.

Al-Azhar’s infertility unit specializes in ICSI, or intracytoplasmic sperm injection. This technique helps give sperm not quite fit for purpose a microscopic push into an egg. Across the lab, another technician was turning dials and manipulating two probes under a microscope, one holding the egg in place and the other injecting it with sperm. Mehany offered to let me watch, and tried to attach a tiny Panasonic TV to the microscope so I could see the moment of conception on-screen. Unfortunately, the connection wasn’t working; the only thing we could get on the TV was a fuzzy rerun of
Noor
, a hugely popular Turkish soap opera from 2008 that had women across the Arab world swooning at its handsome leading man and longing for the romance and companionship generally lacking in their own marriages.
⁹⁴

I asked Mehany what might account for the high rate of male infertility in Egypt. “I don’t know, maybe the pollution,” she replied. “And yes, the smoking.” Her colleagues had other ideas. “It’s the genes,” one of them told me. Egypt has a high rate of consanguineous marriage—as do many other countries in the region—which raises the odds of genetic defects being passed on to children. But that’s not what he was talking about. “Yes, the jeans,” he explained, “lead to elevating the temperature of the testicles, so it damages the testes.”

Aside from theories of fashion-induced infertility, others at the unit speculated that life on the farm, and specifically exposure to agricultural chemicals, might account for the large number of fallahin, or small farmers, turning up. I could see them thronging
in the waiting rooms, men and women dressed in galabiyas. Al-Azhar has an excellent reputation in ICSI, but that’s not the only reason poor patients flock there. There is no shortage of private IVF clinics in Egypt, but the cost of a single cycle of treatment runs to EGP 10,000. At Al-Azhar, treatment is a third the price, and those that social workers deem in need of financial assistance receive further discounts. “Sometimes when couples come and they admit they don’t have money,” says Mervat Mohamed, a professor at the unit, “we think why they need children [if] they can’t [even] afford dressing well? Very, very poor. But one of the ladies, she told me, ‘I hope I can be pregnant, and when I deliver, I want to pass through this procedure’—just to feel that she is pregnant, that you are a woman.” In Egypt, a childless woman is called
maskiina
(pitiful one); the idea that a married woman might be childless by choice is unthinkable to most people.

Test-tube baby making is never easy, but there are additional challenges in Arab countries. Semen, like other bodily fluids, is considered ritually impure in Islam, and ablutions are required of both men and women after sexual intercourse (which explains why, in poorer parts of Egypt where neighbors live in close quarters and often share bathrooms, women will often make a big show of taking a shower—proof positive that their husbands still desire them). Women douche almost immediately after sex; having to wait prone for at least half an hour after ejaculation, on the advice of the infertility specialist in order to promote conception, can be disconcerting.
⁹⁵

The bigger problem, however, is getting a sperm sample in the first place. Many men consider masturbation deeply troubling, and they blame such practices for their infertility. The permissibility of masturbation is something that religious scholars have been grappling with for over a millennium. Al-Shafi’i, founder of one of the major schools of Islamic jurisprudence in the eighth and ninth centuries, said it was haram, drawing on a verse of the Qur’an that specifies believers as those who, among other things, “guard their chastity except with their spouses or their slaves—with these they are not to blame, but those who seek [to go] beyond this are exceeding
the limits”—and that includes your own hand.
⁹⁶
Some jurists disagreed: Ibn Hanbal, for example, founder of another school, argued that masturbation was preferable to adultery and therefore allowed, especially for travelers, prisoners, and others lacking lawful sexual partners; some of his followers even permitted it for women.
⁹⁷
Other religious scholars have compared masturbation to a Muslim breaking the fast during Ramadan because of illness, something that is permitted in Islam; by the same token, they considered masturbation the necessary release of the otherwise harmful pooling of semen in the testicles.
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On the whole, however, religious scholars have weighed in against the practice, invoking hadiths, that, for example, exclude masturbators from God’s mercy on the Day of Judgment, fast-tracking them to hell.
⁹⁹

As a result, having to produce a semen sample for infertility treatment—usually in the clinic bathroom—is problematic for many. The Al-Azhar unit deals with this discreetly, with a room tucked away on a side corridor to make users a little more comfortable. “It happens here many times, we ask him to get a sample and he stays all the day without getting [it],” Mohamed explained. Al-Azhar University is affiliated with one of the oldest and most respected religious institutions in the Muslim world, and Mohamed is a refined, soft-spoken woman in a hijab. So I felt a little awkward asking her if the unit gives patients a helping hand, with pornographic magazines or videos. But she answered without hesitation: “We don’t give them material. We give him the private room and sometimes his wife. He knows the way to do it; he has the instruction before he comes to the clinic. We are not like outside [clinics, where they provide] these sex movies. We don’t provide them with anything, except the cup.”

Islam also sets limits on how far assisted reproduction can go. In Egypt, techniques that involve a couple’s own gametes—artificial insemination, in vitro fertilization, and ICSI—are okay; sperm or egg donation and surrogacy are unacceptable.
¹⁰⁰
Al-Azhar laid down the law in a 1980 fatwa, which has set the tone for Sunni Muslims throughout the Arab world.
¹⁰¹
The reasoning, according
to Sunni authorities, is that reproduction is between a husband and wife; the use of anyone else’s gametes is analogous to
zina
, and the child born of such a union would be illegitimate. The overriding concern here is
nasab
—a child’s relatedness to the paternal bloodline—which determines everything from whom a woman can sit with unveiled to rights of inheritance. As a consequence, such techniques are for married people only—a widow, for example, wanting to use her dead husband’s frozen sperm or their embryos from earlier cycles of IVF, can have a hard time arguing her case.