Schlock Art is where truly tasteless, gleefully grotesque and insanely inventive works of genre cinema are celebrated with unironic fervor. Every other week, we highlight a title available for streaming you may have overlooked. This week, we take a trip to suburbia with Richard Bates Jr.’s disquieting horror / comedy Excision.

Streaming now on Shudder and Amazon Prime

Like malevolent children or exorcists, the “traumatized teen girl takes revenge” horror subgenre has oddly endured throughout the decades. The earliest and most popular example remains Brian De Palma’s 1976 Carrie (which subsequently birthed a sequel and a remake), while films such as Lucky McKee’s masterful May have expanded the genre’s scope as a lens through which to examine mental health. Today’s entry, 2012’s underseen Excision, has much in common with those aforementioned touchstones and, in its best moments, comes close to equaling them.

In this case, our socially-oppressed teenager is Pauline, whose disheveled hair and facial scars, which look less like the result of acne than a flesh-eating virus, are in deep contrast to the Abercrombie & Fitch models that populate her high school. Much of Excision’s success stems from AnnaLynne McCord’s lead performance. She’s all fast-mumbling speech patterns and hunched posture, and her interactions with others are disinterested at best and violently antisocial at worst. It doesn’t take long to be privy to the notion that there’s something profoundly wrong with Pauline’s mental state.

The film opens with the first of several visually arresting dream sequences that serve to key us in on our subject’s warped mindset as well as her abiding fascination with surgery. Pauline, above all else, fancies herself a surgeon-in-training, hoping to one day provide her cystic fibrosis-stricken sister (Modern Family’s Ariel Winter) with the help doctors haven’t been able to provide her.

If all of this sounds troubling … well, it is. But Excision is also frequently hilarious. Writer / director Richard Bates Jr. decides to set his “teen-venge” tale within the comedic nihilism of Todd Solondz’s suburbia. Whereas films like Carrie and May ask us to watch as their eponymous heroines fall victim to cruel torment and misunderstandings from their peers, the script here wisely inverts that trope. Much humor is mined from Pauline’s aggressive (and often appalling) retorts to her parents and classmates; among the first things we hear out of Pauline’s mouth is her asking an irksome health teacher if STDs can be acquired through necrophilia.

One of the film’s blackly comedic highlights depicts a rare sexual encounter between her and a classmate and serves as a microcosm for how Pauline views the world. Notice, from its initiation to the final icky moments of the tryst, Pauline never relinquishes her total power over the situation. She commands every bit of austere foreplay with the same dispassionate manner of a surgeon preparing an operating table. Losing her virginity is something done out of impartial fascination as opposed to adolescent yearning.

Though Excision contains some tremendous cinematography and a mesmerizing central performance, it is unquestionably schlock. The second a film introduces John Waters in the role of a priest, it’s pretty clear how seriously it wants you to take it. Not to mention it’s disgusting. Vomit, menstrual blood, cold sores, and vital organs are all incorporated into what would otherwise amount to a none-more-black comedy about suburban malaise.

It’s clear from the get-go that Pauline’s fixation with medical procedures has almost nothing to do with helping people and almost everything to do with her borderline-sexual interest in people’s insides. Even with this knowledge, much of her detachment is played for laughs … until the ending, that is. The actual depths of Pauline’s madness are revealed in one of the most chilling conclusions to a horror film in recent memory. Excision begins with uncomfortable comedy and ends up, for lack of a better phrase, gutting you.