I think the film takes a good hard look at the MPAA and its conflicts of interest, view of self-importance, and the effect that they have on U.S. culture.
When a film receives an NC-17 from the MPAA several of the largest movie chains will not run the film - plain and simple. This rating also keeps the film from being advertised on the major networks. So an NC-17 is a box office curse. The MPAA "is in bed with" several of the major studios which is actually a conflict of interest and the Federal Government should take a close look at this.
Filmmakers can put most anything into an NC-17 film but when simulated sex is seen as worse then shooting, burning and torturing people (see Indiana Jones and the Crystal Skull) is rated PG-13. Also, check out Pirates of the Caribbean at World's End, also rated PG-13, when 24 people are hanged in the first three minutes of the film including a boy that looks to be about 9 years old - and this one is a Disney Film.
Something is very wrong with a society that glorifies and approves violence for kids but hides sex (something natural for humans) and this film takes an honest look at this issue. I highly recommend this film.
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