What you originally quoted me on was the cultural differences between Japan and some western countries, that contributed to the decision of this being released in Japan, but not the west. I would not rule out more conservative views on sexual content in general as a contributing factor. We've seen many cases over the years where even mature looking video game characters get a different treatment in the west.
However, I think the main difference here may lie in the different age of consent. In Japan it's generally lower than in many western countries. Which means the characters can generally look a bit younger in Japan than in some western countries, and it would still be ok.
I'll link to the pictures rather than posting them to avoid spoilers for people who haven't played it. But it's in the Zero Escape series.
This character here is portrayed as rather childlike both in appearance and demeanor. https://i.imgur.com/74RnIx5.gif
Here's one of the several scenarios where you can find her lying in a pile of her own blood after being stabbed. https://i.imgur.com/raH6ucI.png
In another scenario, this other girl, who not only looks like a young child but is specifically stated to be 12 years old at the time, is burned alive inside of a giant incinerator.
You don't get to see the body (because of the flames) in that particular scene, but in most other scenarios you do. https://i.imgur.com/8rRMj3X.png
The third game is especially graphic: https://imgur.com/vvzztFN
I just started the third one though, so I haven't had any of the children looking characters killed yet.
Dangan Ronpa is another game where children looking characters are murdered and executed in spectacular fashion.
The age of consent in JPN is pretty much the same as most of the world.
Also while I see your point with Zero Escape, I dont see anything that shows the violence being committed to the character. And that gif is not overly graphic at all its an offscreen death. I think this is an apples to oranges comparison here.
Because gun violence is equatable to the sexualisation of children?
It's a drawing and it's sugestion. Theres no depiction of children having sex. I don't know how one can make a case that this isn't ok but blowing heads off in gorish faction is ok. They are both not real. They are controller inputs and polygons or drawings. It makes no sense to take action against one and not the other. Theres no consistency in that position. Either they are both ok cause none of it is real (and tbh one sugests and the other one explicitly does it) or none is because they are representations of reality in entertainment. It's ridiculous. The reason is not to protect anyone. It's cause one sells millions and the other doesn't.
Children having sex? Sorry? This is about children looking characters being sexualised, and being treated as sexualised objects based on various gameplay aspects of the game itself.
Equating violence, to minors being sexualised is not only bizarre, its frankly disgusting.
And tbh, if you cant realise that violence is only more normalised in our society because of historical events (wars, protests etc) and sport (boxing, UFC, fencing, judo), the advent of action entertainment, etc, then I cant help you.
But if you want to argue how the sexual representation of children is ok under certain circumstances then that is your prerogative.