Editor’s Note: This review contains spoilers and mentions of violence, sexual assault, nausea and trauma inflicted on both humans and animals.

When French writer-director Julia Ducournau’s feature-length debut Raw made rounds at film festivals worldwide, paramedics became an occasional fixture of the proceedings as audience members either fainted or left the theater — some without returning, others to empty their stomachs in the nearest bathroom. Despite being produced on a tight budget and given limited theatrical distribution, these incidents have brought the film a grotesquely alluring reputation since its release a few weeks ago.

Historically, other films have garnered similar reactions — The Exorcist is one famous example — and in the case of Raw, its otherwise low profile made the reputation stick. But beneath this reputation lies a film that deserves to be considered for all its facets. It’s a feminist coming-of-age story with psychosexual overtones that wields cannibalism as a potent metaphor for the most painful stages of puberty. Raw handles femininity with a confidence and abandon that is all too rare in a market oversaturated with male writers and directors and represents the start of what promises to be a great year for French cinema.

The film follows teenage protagonist Justine (Garance Marillier), the youngest in a family of strict vegetarians, who is sent by her loving parents to join her sister Alexia (Ella Rumpf ) at a veterinary college. Upon arriving, she is subjected to a series of arcane hazing rituals enacted by the older students — or, as the “rookies” are forced to call them, “Great Ones.” Alexia, a chief Great One, acts as her shy, younger sister’s guide, setting the tone by showing her an array of past first-year class pictures where the faces of those who refused to partake in initiation have been scratched out.

The harshness of the school’s envir-onment directly and intentionally contrasts with the delicacy and compassion required to care for living things, and Ducournau’s screenplay often examines the relationship between humanity and animals. In one scene, Justine faces backlash for claiming that raping a monkey is the same as raping a human; defending herself, she asks her classmates, “Otherwise, why are we in vet school?” It’s an intriguing moral stance for her to adopt, and her reverence for all life seems perfectly tailored to clash with the movie’s most ostentatious plot point: Justine suddenly develops a craving for human flesh.

The dramatic pull of Raw stems from the shocking ways in which Justine’s newfound cannibalism derails her life. After being pressured into eating a questionable meaty snack, she develops a rash all over her skin that seems to mimic a bad allergic reaction. But in one surprising, arrestingly gory sequence, it becomes clear that this condition is much more. This is a radical shift in the very chemistry of Justine’s body, and it’s no coincidence that these changes come on the cusp of her sexual awakening. The target of her desire is one of the film’s only supporting male characters, and her closest friend besides her sister: Justine’s roommate, Adrien. His homosexuality is established early on, but her lust for him grows unabated, smartly conveyed through quiet looks and charged pauses in his presence.

Unaware of her attraction to him, Adrien is always willing to defend his roommate against hazing, even when her sister will not. He’s a clueless fly trapped in the web of Justine and Alexia’s fraught sisterhood, a dynamic exacerbated by Justine’s unwillingness to become the reckless force of nature that Alexia so desperately wants her to be. Adrien’s companionship is fleeting, but Justine’s relationship with her sister runs far deeper. The culmination of the siblings’ arc is equal parts sweet, horrifying and heartbreaking, displaying a deft understanding of the power dynamic between sisters that other filmmakers — specifically male ones — often struggle to grasp.

This is not to say that Raw’s blunt, authentic writing is only insightful because of Ducournau’s gender; she is a virtuosic artist in her own right. Every aspect of the film contributes to a consistent vision, the camerawork and tight physical spaces complemented by a jarring soundtrack that punctuates the rare moments of melodrama with staccato strings and aggressive acoustic guitar. The brilliant use of music lends a sort of twisted comedy to otherwise disarming images, showing that the movie is both aware and proud of its own depravity. The more sickening moments are, thankfully, relegated to the most important plot points, of which there are only a handful, but one would be hard pressed to find a showing of Raw without at least one walk-out.

Raw’s power coalesces in Marillier’s intensely physical performance, one that will no doubt catapult her to further success in the near future. Her commitment to selling even her character’s most debasing moments grounds them in reality, albeit one that seems somewhat separate from our own in its strange, collegiate anarchy.

Those with the stomach to handle it will find Raw a deep film that addresses sexual liberation with an all-too-rare feminist sensibility that treats its heroine with care even as her body and her sister seem to turn against her. It paints puberty as an inevitable machination of fate that chews teens up and spits them out — or, in Justine’s case, brings them to chew on others. Though hard to swallow, Raw will sit in the pit of the viewer’s stomach long after its final reveal.