The title of the film is a reference to Nan Goldin's older sister, Barbara Holly Goldin. It's a direct quote from a mental health evaluation of Barbara during her time at an institution. She died by suicide in 1965, at the age of 18. This film and Nan Goldin's 1986 "The Ballad of Sexual Dependency" are dedicated to her.
Nan Goldin was also depicted as a character (portrayed by actress Abigail Jackson) in the 2021 miniseries Dopesick (2021), about the investigation into the Sackler family and Purdue Pharmaceuticals' marketing of opioids and the resulting effect on patients who (like Goldin) were prescribed them as painkillers but then became addicted.