Never Rarely Sometimes Always shows Autumn (Sidney Flanigan), a 17 year old girl from rural Pennsylvania, performing a song at school. Someone yells a sexist slut at her, temporarily stopping that performance. Sex is an act that involves two people. But girls unjustly carry both the social and physical burden of that act. The latter is specifically true for Autumn, who prefers not to carry a baby to term. Autumn’s options in Pennsylvania have limits. Her mother (Sharon van Etten) is oblivious. Her father or stepfather (Ryan Eggold, looking like a sweaty version of the dad from A Balloon for Ben) doesn’t defend her honor. So she and her cousin Skylar (Talia Ryder) go to New York. The film takes us to that journey, revealing the hell that is American healthcare.

There are a lot of steps that these girls need to take to finally get that abortion. Getting there requires Autumn to be in physical positions, which still feel compromising even if the counselors and doctors are of varying degrees of nice to her. Director Eliza Hittman captures her in these close-ups, showing her reactions to things like ultrasounds, which the local, meaner ‘nurses’ show her to remind her of the life she’s ‘taking’. These many procedures are different from what things like Google say that they’re like. Flanigan displays Autumn’s realizations, her face saying a lot about society burdening her character.

There’s this assumption that audiences can make about the title Never Rarely Sometimes Always, that it refers to her sexual activity. A lesser director would have made it about that, perhaps a male director would, to bludgeon to idea of a slut shaming society. The questions that the New York facilities are technically about that, but Hittman puts a spin on the question. I listened to a podcast episode about a film about a teenage girl. It seems that most healthcare workers catering to girls have to breach the question of sexual assault. And this film shows how those institutions are not good as sussing out that information.

Never Rarely Sometimes Always has this isolating effect even if Autumn isn’t technically alone. There’s Skylar with her. The fact that they’re related means that we’re getting a sliver of their dynamic instead of the film cramming a lifetime’s worth of character development in a trip that they hope would end in a day. That said, this film needs more Skylar. The dynamic between the girls also mirror the one in 4 Months, 3 Weeks and 2 Days, where Skylar has to make an equal sacrifice. And as much as I love Theodore Pellerin, he didn’t need to be in this film.

But as I wrote above, Never Rarely Sometimes Always is a decent showcase for its many elements. There’s the healthcare system, there’s Flanigan’s performance. It puts New York City in a different perspective. There are still the lights that people know it for. But Hittman contrasts those billboards and its Chanel wearing citizens with people like Autumn and Skylar, who themselves have different ways of expressing their gender. The Manhattanites have their eyes everywhere else. The camera, as it should, has its eye on girls like Autumn coming to a state with better laws, hoping to get help that they can’t find at home.

Never Rarely Sometimes Always is available on demand. The film’s Twitter has information on which cities it plans to play. Their website also has links to safe healthcare for vulnerable girls. Don’t be afraid to ask for help, and wash your hands.