In the Netflix series Uncoupled, Michael (Neil Patrick Harris) briefly dates a dermatologist until the doctor unexpectedly suggests Botoxing Michael's butthole to facilitate sex, prompting the question of whether this is an actual practice. Michael is often caught off-guard during the series by contemporary sexual practices because, in a reversal of Neil Patrick Harris' role of Barney in How I Met Your Mother, Michael has not been part of the dating scene in 17 years. The Botox incident could be read as an exaggerated example of him being freaked out by unexpected attitudes around sex and not necessarily a real thing–or is it?
Following Michael’s breakup with Colin (Tuc Watkins), Michael’s father Ben (Byron Jennings) matches his son with his dermatologist, Josh. The two go on a few dates and all seems to be going well. However, when they are ready to hook up, Michael is perturbed by Josh’s prodigious genitalia. In response, Josh (Peter Porte, Brad in Baby Daddy) whips out a syringe of Botox from the bedside table and assures Michael that the medical procedure, performed on Michael’s butthole, will facilitate receptive sex. Michael is surprised by this suggestion and expresses a number of reservations before hurriedly getting dressed and abandoning the encounter altogether.
It turns out that injecting Botox into the butthole is a legitimate medical practice. Anal Botox treatments are provided for certain medical concerns, such as anal fissures and incontinence. It is also practiced for cosmetic purposes, often on gay men and postpartum individuals to provide so-called "anal rejuvenation," comparable to vaginal rejuvenation. People do also get Botox in the butthole to paralyze the anal muscles to reduce pain and thus facilitate anal sex, as Josh attests in Uncoupled.
Is Michael Right To Be Worried About The Botox
While Botoxing the butthole is known to help reduce pain with anal sex, Michael's response to Uncoupled's proposal in that scene is valid. A medical intervention like this should never be sprung on someone suddenly, especially not in a high-pressure situation. The fact that Josh had a syringe of Botox ready to go on his bedside table and did not discuss the idea of using it well before the two were getting ready for sex sends up a number of red flags to which Michael responded appropriately.
From a safety and legality standpoint, Botox is a toxin and can cause life-threatening conditions. As a dermatologist who presumably uses Botox often, Josh is aware of the risks. Botox is also supposed to be refrigerated for proper storage, so keeping it on the bedside table is risky at best. Michael is not given proper information or context to consent, and the Botox is definitely not prescribed to him. Doctors in media often make medical errors, but these factors speak poorly of Josh’s ethics as a doctor and concern for Michael’s health.
Even aside from potential implications for Michael’s health and Josh’s medical license, the way Josh handled the situation was insensitive and coercive. Upon first seeing Josh’s genitals, Michael expresses astonishment but quickly reassures Josh that he can handle him orally. Josh ignores this and immediately expresses his desire to penetrate Michael instead, overriding his objections by springing the Botox on him. When Michael gets up and starts getting dressed while freaking out about how unprepared he is for the kinds of sexual situations he has been pressured into lately, including this one, Josh tries to further coerce Michael into penetrative sex by suggesting Michael accept "just the tip" of Josh’s penis, clearly with no regard for Michael’s distress. Michael is right in Uncoupled not to agree to Botox spontaneously to please a potential sex partner, especially not when that partner a man interested only in his own pleasure and heedless of the harms he could cause pursuing it.