At last year's Toronto International Film Festival, an ambulance was called after “a couple of patrons” passed out during a midnight screening of Raw, the first feature film from the abundantly talented French writer-director Julia Ducournau. And yes, it's true: this movie is gross as all hell. But it's also incredibly sharp, sensitive, and engaging, a coming-of-age story that everyone can relate to—minus, perhaps, a plot twist about eating human flesh.

Raw reveals itself in bite-size morsels, and a second viewing—which I recently enjoyed after the film's romp through the 2016 festival circuit—is rife with ah-ha! clues buried in the script and production design. A critic who gives away too much in a review deserves being chewed out, so I'm using extra caution here.

Justine (Garance Marillier) is a college freshman following in her parents' footsteps at a veterinary school, where her older sister is already enrolled. All we know about the family at first is that Mom is vehemently defensive about her child's vegetarianism, Dad never takes off his scarf, and Sis (Ella Rumpf) isn't there when they drop Justine off.

Before Justine gets to a single class (which, we'll later see, involves intubating a horse and removing impacted stool from a cow), we start in with some good, old-fashioned ritual hazing. French colleges aren't only advanced in allowing coed suite mates; when it comes to initiating rookies, they are unmatched.

In addition to crawling around in their underwear, binge-drinking, and doing a wee bit of Carrie cosplay, there's the gnarly act in which poor underclassmen must eat a chunk of offal. For Justine, who has never eaten meat, pickled chicken kidneys are a no-go, until her sister lays in with the peer-pressure.

Soon after, Justine breaks out in a grotesque rash—the first in a series of ghastly reactions. But as certain changes occur, our quiet and demur lead begins to blossom a bit, and becomes more rambunctious in her bonding with her older sister.

One need not hold a degree in semiotics to see that Raw is very much working as a metaphor for burgeoning sexuality. But what's so refreshing is that the movie also has enough going on to work entirely on its surface-level thrills. Horror fans grow apoplectic when we snooty-pants critics take a movie like The Babadook or The Witch and call them “elevated”—but the truth is that when you compare something like Raw to the dross certain VOD channels pump out each week, there really is a necessary threshold for taking this genre seriously. (Send your angry tweets to @JHoffman; I can take it.)

Ducournau has tremendous filmmaking chops, most evident in party scenes (there are three) that are rich in fervency but not reliant on woozy camera tricks. These sequences are shot in a naturalist style, and they let the chaos of the situation emerge from the performances and outward into the blocking—not by drowning everyone in outrageous lighting effects, as is so often the case. When the violence comes, it's all the more shocking for how tactile it is. This is a movie that digs in its nails.

Despite all that, in the end, Raw is also strangely comforting. The changes young people go through, especially women, can be overwhelming. Here's something to show how you aren't alone, and how it could even be far worse.