It has pain mode and even more painful mode

yeah, normal mode was the original difficulty, terror and starvation was specifically added for ppl who already beat the game and wanted more of a challenge

The Girl and You

While I personally disagree, I am talking with bias since I have watched and looked into quite a bit of its lore. If we're talking about first playthrough and seeing the darker concepts on the surface, they can seem a bit plastered on. Even I can agree that certain parts, like the usage of genitalia on later enemies, kinda gets exasterbated. However, most of elements do provide build up and explore the nature and world of F&H upon further investigation. Again, this is just my take on it, not trying to seem apprehensive or anything like that.

On the author's behalf he stated that these subjects came up from designing the game as "the worst and most hardcore dungeon they could come up with". It isn't a theme of the series and it is largely absent in the second game. My own take is that this game is about pain and human suffering and every element of the setting and gameplay seems to reinforce that theme of human misery. You're in a dungeon isolated from the world where humans can meet gods, it's a place unreachable by civilized reason and morals. There are no human rules, authority or decency and no restraints. I think it would be pretty fake if the game didn't include sexual violence in the grotesque and explicit way it does. It is gross, distasteful and horrifying, but natural and I believe that to be the way it should be. There are plenty of other games with dark unforgiving dungeons and settings that conveniently have this element absent and that's fine, because not every game has to be the same and both takes have the right to exist despite preference.