In Africa, high rates of infertility are due to infection and many other factors. This article explores male sexual dysfunction as both a cause and consequence of infertility in Egypt. Because sexual dysfunction is profoundly emasculating in a country where hegemonic masculinities are competitive, sexually troubled men in childless marriages do not routinely seek treatment from male physicians, leaving their wives to seek treatment for purported “infertility.” However, the medical encounter between elite male physicians and poor women patients is characterized by a “don't ask, don't tell” policy, rendering sexual problems invisible. Furthermore, women are culturally prohibited from initiating sex, but infertility therapies often require them to do so. Marital difficulties in both the performance of sex and gender are the result. The article concludes with speculations on the future of male sexual dysfunction in the era of expanding sex education, sex therapy, Viagra, and new reproductive technologies.
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