Doctor, I think you said in one of your posts that urology is a very interesting and multifaceted field. As I read this, I remembered the joke about the gynecologist who tells patients apart not by their faces but by their vaginas. Are there any jokes like that in your field?
Well, they say that general surgeons recognize patients not by their faces, but by the surgical scars. There is a fair share of truth in this joke, it’s common both for surgery and for medicine in general. Patients actually really like it when their doctor remembers them, because it makes them feel important, special. But it only complicates a doctor’s life. We can’t remember all patients. It’s not that it’s impossible—we just can’t, it’s not a good practice. It makes a doctor more emotional, and an emotional doctor is more prone to mistakes. Urology deals with paired organs, and you could, for example, accidentally cut off the right organ instead of the left one, or vice versa. That’s why patients enter the doctor’s office, get registered and when they leave, they remain on their registration forms, but not in the doctor’s memory. After the patient has left, we must forget about them. This is considered a sign of high professionalism in our line of work.
In von Trier‘s Nymphomaniac, Charlotte Ginsburg’s hypersexual protagonist claims to have created a morphological classification of male types based on genitals. Is it possible to determine a person’s character by their sexual organs? Have you ever tried to do that?
No, I haven’t, because people come to us with specific problems that need to be solved, and that’s what we focus on. Sure, we like coming up with various theories, experimenting and testing them. All people do. But we can’t do that in medical practice, because we are dealing with human life and health here and must use approved methods to solve patients’ problems. Of course, medicine is also a science, and, as in any science, there is also a place for experiments and tests, but there are certain ethical rules to abide by. Experiments should be conducted only in a group, they also require obtaining permission from the ethics commission, and so on and so forth.
Well, I don’t mean large scale research. Just some things that you note for yourself…
This is the first time I’ve been asked this question, so I can’t think of anything, to be honest… Maybe if I thought about it for a few hours, I could come up with something, but not off the top of my head.
We know that female sexuality is a taboo topic in Azerbaijani society, even as an axiom. On the other hand, it’s a topic that is most discussed and causes most negative reaction. Male sexuality is a taboo topic as well, but it’s almost never discussed. Sevda Sultanova writes in her article “A shortage of male body” that the cult of mothers and sisters, the cult of “honor” in Azerbaijan is strongly projected exclusively on women, and yet, for example, in literature and cinema, it is the female body, female sexuality that is emphasized, but not the male body. Why do you think is that?
We are used to looking at Azerbaijani society in isolation from others. But I have long made it a rule to view Azerbaijani society within the context of the Caucasian mindset. Yes, we are Caucasians. All Caucasian peoples have a common culture and a common mindset. I think this is what we need to keep in mind in the first place. Of course, there are features that make Azerbaijani society unique, but we still are Caucasians. So, when I want to understand something about our society, I don’t look at Iran, Turan or Russia. I look at Georgians or Chechens. I look at how Lezgins and Avars live, I look at the relationship inside Balkars, Ossetians, the Ingush and their family structure.
Don’t you look at Armenians? The Ingush, Ossetians—you go that far, but you don’t mention our neighbors.
The situation with Armenians is a little different. This is just my personal opinion. They are greatly influenced by Anatolian culture, and this culture has practically nothing to do with us. For example, among the peoples of Anatolia, Lazi are the closest to us. Even the Kurds of Anatolia are closer to us. You might remember that Pashinyan recently danced Yalli in Shusha. The moment I saw the way he was dancing, I said that these people were alien to this geography—I even wrote about it. Everywhere in the Caucasus, people dance Yalli holding hands, but in Anatolia, they dance it shoulder to shoulder. Some voiced their objections. But I told them to look closer: you can find this kind of Yalli only in Ağdaban, up to Amasya at best—you won’t find it north of Amasya. Everyone dances Yalli holding hands. We lived with the oppressive Arabs, we lived with the Mongols, we lived with the Persians for thousands of years, but we were not Persianized, we were not Arabized, we preserved our Caucasianness. Looking through the Caucasian prism, I see an alien element in Armenians. That’s why I didn’t mention them.
But let’s get back to your question. The Caucasus is a patriarchal region. Of course, it’s not the only patriarchal region in the world, and most societies are patriarchal anyway. I tried to explain the causes of patriarchy before, using tools of sociology and other humanities. Because I like the Caucasian patriarchy, I feel it as “mine”, but at the same time I believe that it must change, and I’m working on it. In fact, patriarchy stems from the structure of our society. We are primates and descended from primates that originated and evolved in the jungles of Africa. The oldest primates lived in rainforests. There is plenty of food all year round there, so there was no need to look for food, grow something or hunt. The most that the first primates did was catch insects or pluck fruit from a tree. They also lived in the trees themselves, so that there was no danger for them. Lions don’t walk around the jungle. The only thing worth fearing was eagles and other big birds of prey, but the trees grew so close to each other that the birds could do no particular harm either.
That is, the first primates essentially lived in paradise. Matriarchy reigns in primate societies where food is plentiful and people live in safety. This is called “female bonding” in English, which means that the family grows through the female line. In “female bonding”, when children are born, boys are expelled from the family, because men are not needed, and if they are, they are “invited” from outside. But over time, the geography and living conditions of primates changed, and when they faced danger, patriarchy first appeared. For example, if we look at some species of monkeys, we won’t see much difference between males and females: they are about the same both in height and appearance. That is, they lack what we call “sexual dimorphism” (differences between males and females of the same species—Ed.). In the first primates, sexual dimorphism is either absent or very weakly expressed. It develops when danger emerges: males begin to grow larger—because the main male hormone is testosterone, which increases muscle mass. The less food and the higher the level of danger, that is, when you have to fight for food and survival, the stronger the patriarchy in primates. This is the case, for example, with chimpanzees and bonobos: they also expel their own females and bring in females from outside to their communities. Now, this is typical “male bonding”, when the family grows along the male line: groups of males with a harem, that is, seven or eight females for a group of three or four male relatives.
Are we still talking about monkeys and apes?
Yes. But humans, that is, the first the genus Homo, evolved in the savannah, where there are many dangers and you have to fight for food. And, if you don’t take care of your offspring, you will lose them. What distinguishes humans from other primates the most is that the male must be involved in the raising of the young. I’m not making this up. This is an accepted theory in biology, especially gender biology. We, humans, were like chimpanzees. Instead of two or three male relatives spending time with five or six females, one male take cares of one female so that she can have a child. This shows that human society is, in fact, inherently patriarchal. As civilization evolves, when food becomes equally available to everyone, and when the issue of danger is regulated by laws and cultures, humans automatically return to their original genetic code, to the first primates, and society becomes matriarchal. However, if a matriarchal society faces a small threat and food safety problems, society automatically becomes patriarchal again. These are the biological roots of the problem.
My fondness for the Caucasian patriarchy doesn’t mean that it should be preserved as it is. In general, there is no need to sacralize cultural memes. They certainly can be changed, and there is nothing threatening for society about this. The Caucasian patriarchy must also be brought into line with the Convention on Human Rights. It’s just that the Caucasus has always been a dangerous place, where you have to fight for food. Here is an example. We were going to climb Mount Kazbek once and, passing through Gudauri, we met a Georgian family. The husband walked in front, mowing the grass, and the wife, with her head covered, was gathering the mowed grass behind him. I said to myself, look, a woman works together with a man. And, for some reason, I couldn’t stop thinking about Arabs: why don’t Arab women work? What would their women even do? At best, milk the goat, treat skins. All this can be done inside the house. If a Caucasian man treats his wife like Arabs treat their wives, he will go hungry. This approach is impossible here. In the Caucasus, women always participate in the family economy. While the man grazes the sheep, the woman gathers and sells greens. So, wrapping a woman in a veil and hiding her from everyone won’t take root in the Caucasus. But it did work with the Arabs.
“Geography is destiny” comes to mind.
As Richard Dawkins said, there are many such cultural memes in the history of mankind. Everyone collects memes according to their geography. If correct, memes live and develop in this geography. If these memes are wrong, they are erased by other cultures and disappear. And I am used to viewing Azerbaijani society within the Caucasian paradigm.
So, why is male sexuality taboo in this paradigm?
Yes, in fact, in the Caucasus, male sexuality and male body are more of a taboo, because a man is the father, the protector. But there is also an economic reason—motivation. There was a study. A group of men as shown different sex scenes: with one woman, with two women, a full sexual intercourse, and so on. Then their arousal was measured. It turned out that at the sight of a female body, regardless of the scene, the degree of arousal of men and their motivation increase dramatically. Then the same scenes were shown to a group of women. Their sexual desire increased at the sight of heterosexual, gay or lesbian intercourse, while men had such a reaction only to female body. When summing up both of these results, it becomes clear that if you want to sell something, be it a book, film, music or some object, there must be an image of a woman, and it must be at least somewhat sexy. This is the economics of it.
As a continuation of the previous question… Because male sexuality is taboo, men don’t discuss their issues, don’t complain and are reluctant bring them up. But they must have more than enough problems. What concerns men the most?
The size of their penis. You should see the statistics on my blog. I have been writing on these topics for a long time, because I get a lot of questions and try to answer them. And since my personal opinion is not yet a scientific fact, I always carefully research each specific issue. There have been cases when the results of my research contradicted my personal opinion. When that happened, I kept my opinion to myself and voiced the scientific conclusion. One of the most viewed entries on my blog was devoted to what gives women the greatest pleasure.
What a curious indicator.
It was, in fact, an extremely popular post. The number of hits was too high for the state my blog was in at the time. I was even surprised, considering that usually our people feel ashamed to talk about it. I get it that people came across that post through search engines and social mdeia, but there were a lot of visits through WhatsApp as well! This means that people forwarded the link to the post to each other via WhatsApp.
Another most popular article of mine was about penis sizes. The fact is that men come to me complaining about the size of their penis. Most of them are students, they have little money. A 19-year-old boy up and comes here from the country. Who knows where he even got the money… And yet he comes and pays for the visit, and then he sits down in front of me, all red with embarrassment. And I say something to him, and it seems to him that has come for nothing. So I decided to make a video and explain everything in it, so that people would watch, understand, and stop traveling so far and wasting their time and money. I shot a video and I also wrote a text post and posted it on my blog. This is my most popular video on YouTube, it already has more than 3 million views. But you know what’s the most interesting part is? The number of requests of appointment only grew. If you had asked me this question two years ago, I would have said, no way, what men are interested the most is female sexuality and so on. I don’t think that now. So, yes, the biggest concern of boys and men is the size of their penis. And this is understandable, because—
Sorry to interrupt, but just for statistics, could you tell me from where you get more patients, from the capital or from the regions? And how old are these people?
From 5 to 45. Sometimes, parents bring their five-year-old children. A while ago, I examined a 12-year-old boy who was brought in by his uncle. Families pay attention to these things.
Shouldn’t a five-year-old boy have a small penis anyway? Can you even know at this age what size it will be in the future?
That’s exactly what I tell them. But they—most often mothers—disagree and insist that their boy’s penis is too small. Every week I get at least two children under the age of ten who have been brought to me because they supposedly have a small penis. So, yes, I do think this is men’s biggest concern. And this is not only a matter of ignorance—at least I don’t think it is. We are all guided, first, by genetically determined emotions, second, by the emotions instilled in us in the family, and third, by the emotions that society teaches us. When I started researching this issue, I saw that articles on this topic are being written all over the world, that is, the same problem exists all over the world. There is even a special percentile curve, that is, the standard, for the size of the male penis. What does this mean? There is no percentile curve for the size of fingers. At most, we look at the thickness of a finger—and that’s only because it matters in the manufacture and selection of rings, i.e., it has economic significance. There is no percentile curve for eye color either. But there is one for a person’s height and weight. And now there is a percentile curve of both girth and length of the penis. This means that the issue is extremely popular, many people around the world have been studying it, and many men’s penises have been measured. In order to get a percentile curve, one needs to take tens of thousands of measurements: four or five hundred measurements will not determine the percentile curve. Moreover, these should be people who do not make a cosmic tragedy of the whole thing.
The existence of this curve means that penis size is one of the most popular topics in the world. That’s why I can’t say about my patients, “Don’t they have things to do, what the hell are they doing?” But I do speak out. Usually, I advise families to focus on the boy’s education, not on his penis, and leave the latter for me to deal with. The problem of a too small penis does exist, but it is very rare. Three to four cases per ten thousand people, or sometimes they say it’s three or fourth per a thousand people. A small penis can be a result of certain diseases or other factors. But, in general, medicine has not found any connection between penis size and a man’s sexual performance.
Do you ask them why they want it? Parents who bring their children, for example.
I used to.
And what did they say?
Nothing. “Why is it not like others’?!”
By the way is it a myth or reality that size matters?
It’s a myth that size matters. And there is one amusing nuance: it’s men with penises of perfectly normal size, even a little above average, who complain the most. It’s so strange. I bought a special ruler in Ukraine that measures the length and girth of the penis. Sometimes I give it to my patients and tell them to measure theirs. Normally I should do it myself, but I leave it to them, to show them that I’m not making anything up. And so the man sees the word “Eurostandard” written there. That’s the size most men have. I tell him, who do you think you are, why should yours be longer? Or there is another comparison that I use a lot. I say, are you Schwarzenegger? Why don’t you have muscles like him? He says, no, I’m not. I say, okay, if you’re not Schwarzenegger, it doesn’t mean you’re worse than him, look at it like that. There are three main reasons why penis size turns into a complex: it’s either what they see in the family, that is, men in their family compare their sizes, or what they see among friends. But the biggest reason is pornography. They watch porn, they see how big the penises on the screen are, and they get depressed because theirs are smaller. But they should look at it the way they look at Schwarzenegger: these are actors and this is a movie.
You said that medicine has not found a connection between penis size and a man’s performance, and that the role of size in sexual pleasure is a myth. So, is this a matter of technique or an innate talent?
A matter of technique.
So, what men need is sex education, not penis enlargement.
Exactly. I ask men who come to me with this issue what languages they speak. They are surprised to hear this question. Why is this important? I sit down, open my iPad, or my computer, and show them that there are a lot of free books on dating and sex on the Internet. I tell them, I have read many of these books. Do you think that those who have read them can be the same as those who haven’t? These are free, just take them and read them. I don’t tell them to go look for these books themselves. Since most of those people are neurotic, you can’t say that to them, it will have little effect. That’s why I open the Internet in a slightly theatrical manner and show where they are. But most of these books are in Russian or English, so it’s difficult for those who don’t speak either of these languages. There are practically no such books in Azerbaijani. Of course, I write on these topics on my blog—as much as possible and keeping within certain ethical limits. But it’s not enough. And my productivity is not high enough to fully meet the demand. Someone else needs to get involved and write about it. There are also few such books in Turkish, but at least they do exist. Still, you have to find those books in Turkish and pay for them, while they are free and much easier to find in Russian and English. Yes, reading these books, learning from them greatly improves one’s technique and skills. There are even special courses that teach quality sexual intercourse, you can find some videos in open access. If you want to learn, you can find everything you need on the Internet. There are excellent video courses in Russian on YouTube on how to improve your sexual life and master new techniques. Just open it, watch and learn! You will definitely learn something. That’s what I want to tell men.
I remembered this quote from Hasan Guliyev’s book Archetypal Azeris: “Azerbaijanis behave as if they don’t have sex at all, as if there is no such thing as sex for them; and it is very difficult to study and analyze something that doesn’t exist.”
There has been this problematic tendency in our society for many years: if the relationship in the family doesn’t work or if a couple don’t have children, only the woman gets the blame. Is that still the case?
Not as much as it used to be. I remember how it was before. In 1992-2003 I lived and studied in Turkey. I returned to Azerbaijan in 2003, and I see that this tendency has significantly decreased since then. But I will say something else. We are used to saying “Azerbaijanis this, Azerbaijanis that” every now and then, as if we were mocking. But do you know how much Azerbaijani society has changed over these 17 years? Our patients have changed too. They have become much more responsible and meticulous. They actually listen to intelligent people now. That is why education is so important. Some may say that, of course, education is necessary, but we should do it delicately, without offending anyone, without being hurtful. But sometimes you will say something that will hurt their feelings. I don’t see anything wrong with someone who has come out of this society, an Azerbaijani, criticizing it. Education is important—whether it’s done with criticism or affection, whip or carrot.
Getting back to your question, as I said, today women are much less likely to be blamed for family problems. I don’t even remember seeing this happen in any family in the last two years. Men used to not go to the doctor at all. And now it’s mostly men who do. Once I had several women sitting in front of me in my office. One of them pointed at the other and said that woman couldn’t get pregnant. I asked where her husband was. The woman said, “What do you need him for? He’s strong as an ox.” I said, “Ox or no ox, he should come and get some tests done.” And now only the husband comes, taking with him a cousin or a friend—but no wife. And when I ask why the wife hasn’t come, they are surprised: “What do you need her for?”. I say, “Well, I have to ask her some questions.” If the problem is about marital relations, then both spouses have to be involved. I don’t know about other fields. There must have been changes everywhere, because these days, there is more information about everything readily available. So, we must continue to talk and write about these topics. Sure, at times I get annoyed at and exhausted by some reactions to my blog posts. But after a couple of days’ rest, I get back to business with renewed enthusiasm.
Here is another one of the recent trends: fewer parents tend to have their boys circumcised, and one of the reasons they give is that circumcision reduces sexual pleasure.
There are some articles about this, but most of them reek of chauvinism. Not every scientific article necessarily reflects reality, you have to know how to read them. There are principles that are almost certainly accepted in science, but there is a certain way to reveal them. There are articles that support the idea that circumcision reduces sexual pleasure, but they don’t offer convincing enough evidence. No, I do not observe a decrease in the number of circumcisions. I say this with confidence, because I perform this procedure as well. But I have observed another trend: some people refuse circumcision, but because it is harmful. Today, the world science and medicine are inclined to believe that in normal societies circumcision offers no benefits, and it can even do harm because, like any surgical operation, it can cause complications.
Is this an assumption or a fact?
It is a confirmed fact. But here is a thing. People in different parts of the world have different living conditions. For example, in some parts of Africa, circumcision is a must. I must also say that circumcision has brought great benefits to human beings in terms of evolution. Circumcision can protect against certain sexually transmitted diseases, so a circumcised man is less likely to be contract sexually transmitted diseases, including HIV, and less likely to infect other people. But normal societies these days have condoms, antibiotics, hygiene. When you think about it, circumcision does seem to be unnecessary and even harmful, since during the procedure, the penis can, for example, be damaged. Still, in societies where hygiene and means of protection are lacking, circumcision is, scientifically, essential for protection against sexually transmitted diseases and HIV.
Responding to one of the comments to your article “Rape fantasy”, Alekper Aliyev said, “Azerbaijanis have a very strong cult of mothers and sisters, a cult of honor, but for some reason when talking about sex, fantasies and so on, these people immediately imagine their mothers and sisters and then begin to accuse their vis-a-vis of immorality.” Why do we, on the one hand, deify mothers/sisters/daughters-in-law and, on the other hand, when hearing something on the topic of sex, we immediately imagine these “divine” beings and lose our heads?
If I’m not mistaken, this is called benevolent sexism. Benevolent, that is, positive, sexism is, for example, praising mothers and sisters, striving to protect them, and so on. And there is hostile, that is, negative, sexism: for example, considering women inferior beings. Sexism is present to some extent in all societies. I read several articles before writing that one and offered my opinion based on them. The authors of those comment act as if we don’t live in this society, or as if there are no social media and smartphones in this society. This is a matter of sexual consent. In some societies the concept of sexual consent is more developed, in some less. A developed concept of sexual consent does not imply immorality. It just means that if you like a woman, you can easily tell her. But there are societies and social groups where you can’t be direct with a woman about it, or you might get in trouble. And there are such people around us as well.
In a conversation with me, they tell me unbelievable things, because I’m a doctor. I have never seen sexually liberated women with such dreams. I’m not saying this because I’m a doctor and have read a lot on this topic. I realized this as a result of my many years of living in Azerbaijan and interacting with the people here. Do you think that a meek and modest girl who doesn’t leave the house has no sexual fantasies? They are the ones who have the real fantasies! On the other hand, there is nothing wrong with having sexual fantasies. It’s not enough that you control the way a woman dresses and her every step—you want to control her thoughts too? What’s next? We used to look at the length of a woman’s shorts, now we’re going to get into her brain? What a weird way of thinking.
Some people have very strong sexual energy. We call this charisma. For example, Malena from the film of the same name. How about men? Nobody comes to mind.
No, that’s not it at all.
George Clooney, Sean Connery… Or Jeremy Irons…
All right, Jeremy Irons.
Sean Connery, for example, was my idol, I even tried to imitate him, his posture, certain gestures. I would watch him on the screen many times and then repeat his gestures and expressions in front of the mirror, and memorize them. I learned some things—the manner of speaking, pauses from Jeremy Irons. When I didn’t know English very well, I would sit and watch Jeremy Irons. Now, when I speak English, people sometimes ask how I got my British accent. And I can’t very well say that I watched certain actors for many years and, even without fully understanding the words, memorized and imitated the intonations. These are models. People generally think and act according to certain models.
I’ll get back to my question. Is sexual energy or charisma innate, or can you develop it?
Yes, you can. There are certain genetic factors that result in a total absence of sexual charisma, sexual life and history. It’s asexuality. A person can be heterosexual, homosexual, bisexual, or asexual—when they are not interested in sex at all. This is mostly genetically determined and difficult to cope with. Everyone else can develop their sexual life in accordance with their orientation and write their own interesting sexual history. But if a person doesn’t work on it, their history may be boring.
And then a man will think that penis enlargement is the only way to become sexually attractive.
It is actually possible to enlarge a penis, but it is a very harmful procedure. I myself have performed this kind of surgery twice. There are some tricks we resort to. I’m not going to go into details now, but we can actually make a penis two centimeters longer and one or two centimeters thicker. However, there are certain complications. First, after the surgery, the penis hangs—I mean, it does get hard but it can’t get upright. Second, the head becomes numb and loses sensitivity. Basically, you take a living organ and turn it into a stick. Of course, if nature was less than generous with a man and gave him a short penis, then when you make it two centimeters longer, you make such a man very happy. So what if this enlarged penis works like a stick—it will still make the man happy! But to do this for a man with a normal penis size just because he wants it “a couple centimeters longer”… That man will feel worse than before the surgery. That’s why this surgery is not performed for penises longer than six centimeters. Some surgeons did try, but the results were tragic. For example, there is a procedure they do in prisons, where you can make the penis thicker and larger by injecting certain available drugs under the skin of the penis. Again, I will not go into details, in case some readers decide to try this on themselves. But I have met many people like that, it’s common in prisons, because domination is important there. It ends very badly. In the first few years, everything is fine, but then serious problems begin. For many of these men, we had to amputate their penis. That is, those trying to enlarge their penis in this way will end up with no penis at all.
That was the last question. Thank you for your time.
Interview by Aygun Aslanli