In some specific scenarios, it seems like there's a direct gameplay disadvantage to playing the censored version on windows.
Since you can't take off underwear, it takes way more sacrifices to take advantage of the "Unburdened" positive quirk (if total durability is lower than 100, +50% physical damage), since the base underwear's 50 durability is pretty significant compared to trinkets. You basically HAVE to sacrifice your armor slot, when you could have simply unequipped a trinket and underwear otherwise.