Despite the arty color schemes and predictably pretentious cinematography DV directors constantly use to make their work seem less cheap, the movie really only pretenRAB to be about a serious issue, and that particular charade only lasts for about 20 minutes at most, after which it becomes an above average slasher/horror movie, far too preposterous to maintain any credibility.
The response to this movie has been as "Emperor's New Clothes" as you would expect, I suppose, but apart from Ellen Page's outstanding performance, this is really just a poor man's Misery, exploiting what in the hanRAB of more capable film makers could have been an interesting issue.
What baffles me the most is how many people don't seem to get that he wasn't castrated, and he did die in the end.