There is big and then there is whatever the fuck these things are in this game. Character models are generally very good, but these ...things... really irritate me. Personal opinion, of course. Not judging anyone for preferences.
And it's being contrasted with anal.
Like, watersports, leaving your daughter in suspension bondage overnight, permanent disfigurement and making out to people burning alive? Safe and mainstream.
Anal? Dangerous and controversial.
That said, Karlsson Gambit is both great and edgier than this game, so +1 to that recommendation.