I've seen similar images, where a woman had her mouth covered with tape. Though the tape is symbolic, the woman could theoretically remove it. This image conveys way the true terror of being silence & someone else holding the key. The brutality of being silenced, not with the use of persuasion or ideas, but with brute force. It is jarring in the way that we should always be knocked over with anger every time we encounter that we live in a world where such an image must exist.