Which of the following two statements is true about the show Nip/Tuck, which has its fifth season finale tonight on FX?

Created by the openly gay Ryan Murphy, Nip/Tuck is one of the most gay-inclusive shows on television, seamlessly integrating scores of gay characters into its storylines and featuring many openly gay actors in both gay and non-gay roles.

Nip/Tuck features a never-ending parade of hoary gay stereotypes, with over-the-top characters that often seem to have been created specifically to shock or offend, or at least with little regard to how they might be reinforcing prevailing negative media images of gay and bi men.

Weirdly, both statements are true. But how can that be? How can one of television’s most gay-inclusive shows also feature such negative portrayals of gay and bisexual men, especially given that it was created and is still overseen by a gay man?

Therein lies the gay paradox at the heart of Nip/Tuck: one of the most gay-friendly shows on television seems at times to be one of the least gay-friendly.

(Warning: some clips contain language that may not be appropriate for work.)

Physicians Not Healing Themselves
From the beginning, Nip/Tuck was something different.

The Fox cable channel FX, which stands for ”Fox Extreme,” made a big splash with their first foray into original programming with The Shield, a gritty 2002 cop drama. Nip/Tuck, their second all-original show, came a little over a year later and was clearly an attempt to not just build on that success, but to firmly brand the network as the place to go for provocative, edgy fare.

In retrospect, Nip/Tuck seems like a picture perfect attempt to call attention to itself, a Simpson’s parody of an edgy TV show: explicit sex scenes of every imaginable variety, gore as graphic as anything even on subscription cable, and shocking storylines often ripped straight from the headlines. As the seasons passed, the show also snagged more and more high profile guest stars willing and eager to send up their own media images.

Creator Ryan Murphy, who has been the show’s sole showrunner for each of its five seasons, declined to be interviewed for this article, but in 2005, he told The Hollywood Reporter, "I think the great thing about our show is that every year we push the boundaries of what television does.”

But the most shocking element of the show has never been the graphic sex or gore; it’s the fact that the main characters were almost unrelentingly negative.

Nip/Tuck is a show about plastic surgery — about the team of two plastic surgeons, Christian and Sean, and the patients they transform. “What don’t you like about yourself?” is the show’s catchphrase, spoken by the doctors at the start of every episode. But one of the great ironies of the show is that changing a person’s exterior often doesn’t make any difference on the interior, which is usually where the real problem lies.

Is Nip/Tuck anti-gay? Some gay people think it is. “Whenever I write anything nice about Nip/Tuck, I get plenty of comments and emails from gay folks, saying, ‘How can you say anything nice about such an anti-gay show?’” said AfterElton editor Michael Jensen.

But the reality of Nip/Tuck is more complicated than that. As with every patient who goes in for or emerges from plastic surgery, what we see on the surface isn’t necessarily a reflection of what is underneath.

Christian Troy (Julian McMahon), one-half of the plastic surgeon partnership, is a sadistic, misogynistic narcissist and a pathological liar. Sean McNamara (Dylan Walsh), the other partner, pretends to be ethical, but is pathetically insecure and quick to make moral compromises. Meanwhile, Sean’s wife Julia (Joely Richardson) is, at least at first, a stifled, furious sell-out of a housewife, and their brooding son Matt (John Hensley) is so lacking in an identity that he latches on to whoever showed him the slightest amount of attention.

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