The Substance: Body Horror and Feminism

Coralie Fargeat’s The Substance (2024) is an electric continuation of the body horror canon. Rather than focusing primarily on the body’s unpredictable transformation, Coralie Fargeat’s film examines the systems that teach us to fear our bodies in the first place. Its horror is rooted not only in aging and physical deterioration, but in a culture that treats women and femme’s bodies as commodities whose value depends on their continued desirability. Here, the pursuit of bodily control is not just an individual response to mortality. It is an expectation reinforced by institutions that profit from making people feel inadequate, and that offer interventions without necessarily taking responsibility for their consequences.

Elisabeth

Our first introduction to Elisabeth Sparkle (Demi Moore) is an inanimate object. A star on the Hollywood Walk of Fame. We watch Elisabeth Sparkle’s star appear, celebrated and carefully maintained. Over time, public affection gives way to indifference. The star becomes cracked, soiled, and disregarded, reflecting the trajectory of Elisabeth’s career. When we meet her, she is an Oscar-winning actress hosting a televised fitness program, performing physical vitality to maintain her professional relevance. On her 50^th birthday, she is fired for being “out of her prime.” Her producer, Harvey (Dennis Quaid), cannot articulate what she has lost beyond passing an arbitrary age milestone, but the message is clear: she is no longer desirable.

It is clear that Elisabeth’s experiences up to this point reflect a legacy of institutional harm. Hollywood has rewarded her for her appearance while making her professional value contingent on maintaining it. As that value diminishes, so does her sense of what remains possible. By the time she encounters the Substance, she is confronting the possibility of losing the recognition, belonging, and purpose she has spent her life pursuing.

The Substance and Its Purveyors 

After a car accident brings Elisabeth into contact with the medical system, she is confronted with her mortality at a moment when she is already struggling to imagine a future. At her most emotionally vulnerable, she is presented with a mysterious intervention advertised as a way to create a better version of herself. The Substance promises to restore what she believes she has lost, allowing her to experience the validation and opportunities she fears are no longer available to her. Elisabeth is susceptible to this promise because she has been taught to see her body as the problem. Her decision reflects the collision of a long history of devaluation with acute existential distress. 

The process requires Elisabeth to inject herself with an activator that causes her body to split open and produce her “other self,” a perfected (read: younger) version of herself. The two must alternate living in the world, each occupying one week while the other remains unconscious. They share a single life force: Sue can sustain her own existence only by extracting spinal fluid from Elisabeth. The arrangement comes with one essential rule, RESPECT THE BALANCE.

Yet the system providing the Substance offers little meaningful guidance about what Elisabeth is agreeing to, what risks she is assuming, or how she might navigate complications. She receives instructions, a phone number, and a locker containing the supplies she needs. From there, she is largely on her own.

The purveyors appear to know that maintaining the balance between Elisabeth and Sue is essential. Their warnings suggest they know what happens when that balance is disrupted. Still, they provide no meaningful oversight or proactive support. Information is fragmented, and Elisabeth must recognize danger as she experiences it. She is given enough information to participate, but not enough to understand fully what participation will demand of her. 

Sue

The film makes the physical costs of Elisabeth’s decision impossible to ignore. Her transformation into her “other self” who comes to be known as Sue (Margaret Qualley) is graphic and invasive. Elisabeth’s back splits open, and Sue emerges through her flesh. Later, Sue sutures Elisabeth’s back closed, the needle roughly piercing through skin. These are not surgically realistic depictions, but their practical effects make the high cost of the transformation visceral. 

It is clear early on that Sue will not be respecting the balance. Inevitably, Sue begins extracting more of Elisabeth’s life force to extend her own time, while Elisabeth’s aging is accelerated and magnified. She loses her hair and develops extremely exaggerated degeneration in her joints and spine. Her physical deterioration is the body horror, while her appropriated self-loathing is the deeper psychological horror. Despite the consequences, she is willing to continue to expend her life force, if it allows her to be adjacent to love and recognition through Sue. 

Monstro Elisasue

Meanwhile, Elisabeth and Sue become increasingly hostile toward one another. Sue leaves Elisabeth on the bathroom floor for days, treating her own source of vitality as disposable. Their relationship makes visible the logic of the system itself: one self is celebrated while the other must absorb the cost. Sue initially experiences beauty as liberation, but gradually internalizes the same demands that constrained Elisabeth. She extracts more and more to sustain the version of herself that others reward.

Having completely depleted Elisabeth, Sue begins to deteriorate. Even as Sue suffers, her pain remains invisible so long as she can perform beauty. When she can no longer maintain that performance, admiration turns to disgust. Desperate to preserve her youth, Sue ultimately uses the activator again, despite the warning against doing so. The result is Monstro Elisasue, a grotesque composite of the two selves that can no longer sustain the appearance either was created to maintain. The crowd recoils in horror, violently rejecting the body that no longer conforms to its expectations. In the final moments, Elisabeth’s face separates from the monster and crawls back toward her star, reduced to the image through which she sought to secure her place in the world. In the end, she is literally just a pretty face... with no substance. 

Barbie for Freaks 

The Substance is my Barbie (2023). Elizabeth’s tragedy is that she has internalized the misogynistic and ableist messages that her body is the condition of her worth. The Substance offers a way to preserve that worth by changing her appearance. But the promise rests on a more fundamental fear: that without beauty, she will become invisible, unlovable, and ultimately disposable. The film makes this fear tangible through Elizabeth and Sue, whose struggle for survival becomes inseparable from their struggle to remain desirable.

Although Elisabeth and Sue turn against one another, they are both casualties of the same oppressive system. Each is rewarded when she meets its expectations and punished when she falls short. Sue initially experiences youth and beauty as freedom, only to discover that the freedom is conditional. She, too, must maintain perfection to keep the attention she has gained. 

The fear of rejection can be a powerful motivator, even when rejection is not inevitable. Elisabeth and Sue are responding to the feared implications of aging. Their choices unfold within a culture that makes perfection feel like the currency of belonging, while offering little reassurance that they will still matter when they can no longer pay. The horror lies partly in how readily that fear can be mistaken for a personal failing, rather than understood as a response to the conditions in which these women live.

This is where The Substance extends the questions raised by body horror more broadly. The genre makes bodily change frightening by rendering it grotesque, inviting us to recoil from the body that no longer conforms to expectation. Fargeat’s film also asks us to look beyond the transformed body to the systems that establish those expectations, profit from the fear of failing them, and leave people to bear the consequences. The Substance promises control, but it cannot deliver safety, connection, or lasting security. It changes the body without changing the conditions that made transformation seem necessary.

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Read part one and two of this month’s body horror deep dive here and here.

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