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Cultural implications The American version of Queer as Folk quickly became the number one show on the Showtime roster. The network's initial marketing of the show was primarily targeted at gay male audiences, yet a sizeable segment of the viewership turned out to be straight women.

Groundbreaking scenes abounded in Queer as Folk, beginning with the first episode, containing the first simulated explicit sex scene between two men shown on American television (including mutual masturbation, anal sex, and rimming), albeit more tame than the scene it was based on in the UK version. Despite the frank portrayals of drug use and casual sex in the gay club scene, the expected conservative uproar never materialized.

Initially, most of the actors kept their real-life sexual orientations ambiguous in the press so as not to detract from their characters, causing much speculation among the viewing audience. Since that time, Randy Harrison, Peter Paige, Robert Gant and Jack Wetherall have stated that they are gay, while the remainder of the cast have stated they are straight or have avoided public discussion of their orientation.

Controversial storylines which have been explored in Queer As Folk have included: coming out, same-sex marriage, recreational drug use and abuse (cocaine, methamphetamine, ecstasy, GHB, ketamine, cannabis); gay adoption, artificial insemination; vigilantism; gay-bashing; safe sex, HIV-positive status, underage prostitution; actively gay Catholic priests; discrimination in the workplace based on sexual orientation, the internet pornography industry and bug-chasers (HIV-negative individuals who actively seek to become HIV-positive).

The series was set in the city of Pittsburgh, Pennsylvania, which it depicted with a good deal of creative license. Pittsburgh was chosen as the closest parallel to the UK series' industrial setting of Manchester, England. However, since Pittsburgh does not have a large gay district like San Francisco or New York, almost all of the Liberty Avenue scenes were filmed in and around the Church and Wellesley area of Toronto which is that city's gay village. In fact, not a single shot of the real Liberty Avenue was ever used in the series. Toronto was chosen as the production center of the series because of its lower cost of production and established mature television and film industry. And, as it happens, Toronto's gay village had the look the producers needed to bring their vision of Liberty Avenue alive.

Woody's, the central bar in this fantasy Pittsburgh, is the name of a leading gay bar in Toronto, whose real exterior was shot with only minor disguise. (In a Season 4 episode in which several characters travelled to Toronto, the real Woody's was dubbed "Moosie's".) While Pegasus, the most popular gay club in Pittsburgh, is located on the real-life Liberty Avenue, it is not the gay mecca that is portrayed on the show.

The series has, at times, made humorous reference to its image in the gay community. A few episodes featured show-within-a-show Gay as Blazes, a dull, politically-correct drama which Brian particularly disagreed with, and which was eventually cancelled.

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