There are many instances of sexual violence portrayed throughout this film, with flashback to the rape of the main character from the first film in the installment (which opens this sequel). Rapists are always male assaulting cis women and the movie contains several scenes of sexual violence against men and the mutilation of male genitals. Some of the film takes place in a group therapy setting, which is not a safe place and ridiculed by the film. There are frequent visits by the cops, a male member of the group frequently loses his temper, yells, throws chairs and storms out and the therapy leader touches the protagonist (hug and pet her face) when she does not consent. Additionally, the protagonist's private therapist emphasizes that forgiveness is the only way to heal. A teenager in the group therapy tells about her step-father continuously assaulting her. It is later revealed that she still lives at home with him and that her mother does nothing to protect her. The man is killed by the main character when she uses a sledgehammer to insert a metal pole into his anus, the scene is shown in graphic detail and blood splashes on her face. A male character in the group therapy tells about his daughter killing herself as a result of being raped by her trainer. The main character tracks him down and attempts to kill him but fails and is only saved from him attempting to rape her by a police detective who shows up at the last minute. This negates the series' guiding light, which is that the protagonist will get revenge instead of the broken judicial system. The protagonist and her friend follow an old, drunk man back to his house from the bar and pull his pants down and scare him after he made a victim blaming comment: he subsequently pisses himself and they laugh and run away. A group of men harass the main character throughout the film. She is also forced to perform oral sex on her friend's killer (her abusive ex boyfriend): she cuts his penis off and kills him.