Never Rarely Sometimes Always gets its name from a pivotal scene. 17-year-old Autumn (played by newcomer Sidney Flanigan) is asked a series of questions at a women's health care clinic in New York. She's come for an abortion, having traveled to the city from smalltown Pennslyvania after discovering that the procedure requires parental consent in her home state. But first, she has to answer a series of probing questions about her sexual history. As the teen responds to each inquiry with a hushed never, rarely, sometimes, or always, she's forced to reckon with her own buried traumas. It's a brief moment of vulnerability; a much-needed release.

Filmmaker and screenwriter Eliza Hittman views her work as "portraits of pain," she tells MTV News over the phone. Like many new releases this month, her third feature premiered through on-demand platforms after theaters across the country shut down in the wake of the novel coronavirus pandemic. Never Rarely Sometimes Always is a bit of tough sell in the social distancing era. It's not a feel-good romp, soapy teen melodrama, or family-friendly adventure. It's a quiet glimpse into one teen's life, a story of girlhood, and a snapshot of a frustrating  health care system that often fails women and marginalized communities. Filmed over the course of 27 days, the heartrending drama depicts loneliness and emotional isolation, which is even more potent today when human connection is hard to come by.

In this conversation with MTV News, Hittman talks about her inspiration for the film, what makes the teenage experience so creatively compelling, why she prefers working with emerging actors, and how Autumn's personal story speaks to a universal issue.

MTV News: A through line in your work, from Felt Like Love to Beach Rats to this film, is the teenage experience. What makes teens so compelling for you as a storyteller?

Eliza Hittman: I've only really gravitated to work about youth and about the representation of youth. You grow up watching all these classic John Hughes movies, and films about what it means to be a teenager and a young person in the world. And it was so hard to see myself and understand myself through those movies that I always sought out films that showed a more complicated understanding of the challenges of being a young person — that growing up is so much a process of disillusionment, having the way that you think about yourself and think about the world becoming disillusioned.

MTV News: The young characters in your film, especially in this one, Autumn and Skylar, convey a lot of emotion through silence. They're not the typical teens you see on-screen. 

Hittman: I'm always more concerned with the way that they feel, the way that they act, more than I'm concerned with capturing the way young people really talk. And it's about showing these very intimate private moments that you wouldn't see in other movies about young people. I always think about films as being kind of outtakes.

MTV News: Sidney Flanigan is such a revelation in this film. Since you focus on the way that young people act and the emotions that they don't always articulate, how did you collaborate with Sidney to develop the character of Autumn? 

Hittman: One of the real challenges always in casting young people is finding young performers that have real inner worlds on screen, and real visual, intellectual, and emotional complexity. Sidney auditioned for the film. She'd never done a movie before. And yet I could feel from her audition that there was such an emotional depth in her, and vulnerability and sincerity, and fragility. But what was most important to me is that she didn't feel like a victim. And a lot of people auditioned, and the first thing their impulses were to amplify a sense of victimhood. Sidney didn't do that.

MTV News: Did you work with her to bring Autumn to life, or did you already have the vision in your head of who this teenager was and what you needed Sidney to do? 

Hittman: We didn't have much time. One of the joys of working with young people is that they really grasp the immediacy of acting. And so Sidney and Talia [Ryder, who plays Autumn's cousin Skylar] were so much fun to work with because they just got it. They dove in. We had a couple of days to answer questions and work on building their relationship, just as young women, not as characters. But we all just dove into the shoot. I think Sidney brought a lot of herself to the role, but nothing gets improvised.

MTV News: You had the initial idea for the film after reading an article about the death of a young woman in Ireland. But you decided to set it in the United States. Obviously, a woman's access to safe reproductive care is a global issue. Was there a reason why you made this an American story? 

Hittman: Initially, I did want to make a film set in Ireland. It wasn't challenging, unfortunately, to think about ways to translate the story here. Because there are so many women who travel from rural areas to urban areas to access reproductive care. So for me, it was about wanting to be specific. I didn't want to tell a general story. I'm not making a documentary.

I picked Pennsylvania, and I looked at the restrictions of minors that exist in that state. And I really just tried to think about, through talking to doctors, what the journey would really look like. It's specific to a minor in Pennsylvania. But of course, it's a journey that women take all over the country.

MTV News: It contextualizes a larger issue. 

Hittman: I think in telling localized stories, you're able to tap into something universal.

MTV News: This is Autumn's story, but we never learn much about her. The film takes place over the course of a few days, and while she's harboring a lot of pain, and a lot of angst, the sources of that pain are never fully explored. This is just a small snapshot of her life. Why is that? 

Hittman: It's like you said — it's a story where you just spent three or four days with the character. And I always knew that the story was so much about the obstacles in getting the abortion, and I wasn't telling a family drama. So I wanted the audience to feel things about her world and feel things about her family life, and just get a sketch of her world without making it the focus of the film.

MTV News: You're a filmmaker who's established her own aesthetic and her own point of view. How would you describe your work?

Hittman: Challenging. They're lyrical portraits of characters in pain.

MTV News: Why is that so compelling for you to depict on screen? 

Hittman: It's a truth to our experience. And especially with this film, it's so much about the pain and loneliness of having to go through this by herself. A lot of women will watch the movie and know somebody who went through something similar, or might've gone through something similar alone. Abortion, it's a reality. People need abortions. People go through these experiences, and the fact that it's such a stigmatized subject and controversial subject makes it difficult for people to find community around what they've been through.

MTV News: You've said that this is an important film for young people to see, specifically young women and conservative men. Why is that? 

Hittman: It's an important film because we live in a country where it's so hard to get access to our reproductive rights, which are our Constitutional rights. And I don't think women should have to suffer.