Around the time of the
American Pie movies, I considered not watching any more films whose titles start with "
American..." but then remembered that
American Gigolo and
An American Werewolf in London are among my favorite films.
The Girl with the Needle was an interesting watch so soon after revisiting
The Elephant Man as part of my Lynch retrospective. The Lynch film clearly has an influence on this one, especially in the sideshow scenes.
As for the accusation that the film exploits Peter's appearance for shock, at the time it had been pointed out that The Elephant Man plays like a classic horror film for its first act, including the reveal of its title character. Von Horn must have been aware of this, as he proceeds differently. The revelation is delayed because Peter is ashamed of his appearance, when Karoline demands of him to remove his mask, this could have been an opportunity for a shock reveal. When he finally removes his mask on his own terms, it is a gradual process, and from then on the film takes a matter-of-fact approach to his face, never lingering on it. Later, he shows his face to a baby he is holding, knowing it has no preconceptions and won't look at him in shock or revulsion.
Accusing this of looking like a Saint Laurent ad just because its B&W is a cheap shot, the cinematography does an extraordinary job of recreating the look of contemporary photography, especially in the street scenes.
In court, the killer defends her actions by blaming society and (as MichaelB states) the limited to non-existent agency of women at the time, but she's not entirely wrong that this society has to take part of the blame. But I don't see why her desperate attempt at saving herself from the gallows should be held against the film, she looks crazed as she justifies her crimes. I saw a bit of Fritz Lang's M in the court scene, which also must have served as a visual reference. BTW, the real serial killer the film was inspired by based her defense around the claim that she was abused as a baby, which would have been far worse if kept for the film.
More importantly, that's not how the film ends. Given the accusations of "miserablism", it comes as a surprise that the film ends on a hopeful note, which, if the film is as miserable or nihilistic as suggested, is not the obvious way to end this.
In terms of the limited opportunities available to women in the early 20th century, this also struck me as a working-class counterpart to The House of Mirth, which showed that even socialites had little agency other than to inherit wealth or marry well. Without resorting to anachronistic attempts at a feminist statement, Karoline, for all her bad luck, never comes across as a passive victim. She is quite resilient, to the extent that she sometimes seems unsympathetic, and Vic Carmen Sonne's performance never pleads for our sympathy.