Editorials

‘Excision’ Brings One Woman’s Morbid Fetish To Life

Uterus Horror is a subgenre of films that focuses on the experience of growing up with a female gender expression. These films capture the act of becoming an adult and coming into your sexuality, using horror to emphasize and/or act as a metaphor for those experiences. Columnist Molly Henery, who named and defined the subgenre, tackles a new film each month and analyzes how it fits into this bloody new corner of horror.

September 8th, 2023 | By Molly Henery

High school can often be a tumultuous time in a person’s life. Not only is your body going through changes, but it’s also a time when people are trying to figure out who they are. It’s confusing enough for most, but imagine if, during this time, you also realized you had a deep fascination with, and even attraction to, blood and corpses. This is the case in this month’s Uterus Horror film, Excision.

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Excision is a 2014 horror-comedy written and directed by Richard Bates Jr. (Suburban Gothic, Tone-Deaf), adapted from his 2008 short film of the same name. The film tells the story of Pauline (AnnaLynne McCord), an awkward high school senior with ambitions of being a surgeon. Not only is Pauline an outcast at school, but she is also an outcast in her own home. She has an overbearing, religious mother (Traci Lords), a detached father (Roger Bart), and a little sister named Grace (Ariel Winter), who has cystic fibrosis. The only person who shows Pauline any love and affection is Grace. 

While there is clearly love between the girls, they are also very different people. Pauline is a loner obsessed with medicine and has no interest in things considered “girly,” while Grace is all about fashion, boys, and her friends. Pauline has no one she can confide in.

It’s almost immediately clear that Pauline’s mind has conflated her fascination with medical procedures with her budding sexual desire. Throughout Excision, she has sex dreams that typically involve her being aroused as she performs gruesome procedures on people – both living and dead – as blood flows everywhere. Pauline even asks her teacher, “Can you get an STD from having sex with a dead person?” during sex ed. This strange sexual desire escalates to the point that she’s finally ready to lose her virginity, but only while on her period. 

True to her awkward, up-front personality, Pauline asks a popular boy at school named Adam (Jeremy Sumpter) if he wants to take her virginity. While he acts disgusted by this proposition in front of his friends, Adam ends up arranging to take Pauline to a hotel to do the deed. After bluntly telling Adam the “big” condoms he brought are too big for him – which briefly emasculates the teenage boy – they finally have sex. During sex, Pauline fantasizes about flowing blood covering Adam and the bed in the thick, red liquid. Once the fantasy subsides, Pauline instructs Adam to go down on her. He happily obliges until he realizes too late that Pauline is on her period and runs to the bathroom, his face covered in her blood.

Throughout Excision, Pauline’s behaviors are concerning and borderline psychotic. Her infatuations likely could have been addressed and curtailed sooner if it wasn’t for her mother, Phyllis. Both of Pauline’s parents realize their daughter is different. Instead of taking her to see a psychiatrist, Phyllis forces Pauline to regularly meet with their priest (John Waters). Naturally, the deranged sexual fantasies of a teenage girl are no match for a priest, and their sessions abruptly end. 

Phyllis also tries to force Pauline to do things she believes will turn her into a proper young lady. Namely, Phyllis enrolls both of her daughters in a cotillion program, which involves teaching young girls manners and etiquette before they are introduced at a social dance. This is a perfect example of Phyllis not recognizing her daughter is approaching adulthood. It isn’t until the night of the Cotillion dance that Phyllis finally recognizes her mistake. Grace is the right age for such an event, but Pauline is far too old and is even more of an outcast among the preteens.

Eventually, everything in Pauline’s life comes to a head. She overhears her parents talking about her behavior, and her mother essentially admits that she doesn’t love Pauline. A popular girl vandalizes Pauline’s house, so she retaliates by going straight up to that bully and kicking her ass at school, which naturally gets Pauline suspended indefinitely. She even carves a medical cross into her arm as a sort of tattoo. Phyllis finally realizes Pauline needs professional help and schedules an appointment to meet with a psychiatrist the following week. Unfortunately, the family also gets the news that Grace’s cystic fibrosis is worsening, and she must be added to the lung transplant list. 

Pauline, fearful of losing the one person who loves her and desperate to make her parents proud, devises a plan. While her mother is out for the night, Pauline drugs her father and ties him up so he’ll be out of her way. She then drugs a neighbor girl, as well as Grace, and moves them to the makeshift operating room she’s created in the garage. Pauline performs a lung transplant, taking the healthy lungs from the neighbor girl and using them to replace Grace’s bad lungs. Her delusion is so strong that Pauline doesn’t even realize Grace has been dead through the entire procedure. 

Phyllis finally comes home and sees what Pauline has done in the garage. At first, Pauline excitedly explains the surgery, convinced she has succeeded. It isn’t until Phyllis holds Pauline close and screams in horror that Pauline seems to finally snap back to reality, screaming along with her mother as they both mourn Grace.

Pauline’s Uterus Horror story in Excision is tragic, but it’s also a tragedy that could easily have been avoided. While her parents likely didn’t know the full extent of Pauline’s strange sexual desires, they obviously knew their daughter needed psychological help. If they had taken her to a psychiatrist from the beginning – or even if she had a close friend she could fully confide in – Pauline’s delusions of grandeur and infatuation with gore likely could have been helped. But Phyllis is a woman with very strict religious ideas of what is proper for a young lady, and that doesn’t involve psychiatry, sexual expression, or anything that the outside world would consider abnormal. By the time she finally accepts Pauline needs professional help, it’s too little too late.

Excision is both a Uterus Horror film and a cautionary tale. It has many of the classic elements commonly found in this unique subgenre. The film has a protagonist who is an outsider with no friends other than her sister. Pauline is also a bit of a late bloomer compared to her classmates and struggles to find her place in the world. To that last point, some might argue that Pauline knows herself and her place because of how assured she is in her goal of becoming a surgeon. While that is true, Pauline is still discovering how her professional goals are intertwined with her sexuality. She is also trying to learn how she fits within her own family, at first shunning her parents and then craving their love and approval. 

As for the cautionary tale of Excision, the one takeaway I hope viewers have is the importance of therapy with a professional. Had Pauline seen a medical professional rather than a priest when her odd behaviors first arose, her story would likely have been quite different. She would have had someone to temper her delusions of grandeur and help her better understand why she was sexually aroused by medical gore. Pauline is an extreme example, but the larger point is that this is a difficult time in every teen’s life. Therapy can help them navigate it and give them the tools that will lead to better mental health. It isn’t something to be ashamed of. The horrors of adolescence can be far less terrifying with a medical professional guiding the way.