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SvennoJ said:

How hard is it to make a foreign PSN account?
How do people in those countries play on Playstation?
How do other games on Steam that require Microsoft/PSN/Publisher accounts get sold?

I've had a US Amazon account since the 90s, as well as a UK one as it wasn't available in my country. And I've tons of 'useless' accounts nowadays, EA, Origin, Ubisoft, Microsoft, Square Enix, Capcom, Epic, Bethesda, Roblox, and PSN accounts. Heck in GT Sport many people also had EU and Asian PSN accounts to race on other servers.

It would be nice not to have to make all those accounts, yet kinda baffling why HD2 is suddenly the hill to die on?

Heck my Password 'file' has over 200 different passwords for all different kinds of accounts.

That’s no longer what the problem is. No one in any of these non-PSN supported countries can now buy Helldivers 2 on Steam and by extension by those who have already purchased the game to be defacto banned. And trying to circumvent this by VPN breaks Sony’s TOS and can risk being permanently banned. 

It was already an unrealistic request to ask an unknown number of thousands, if not millions, of people to “just change your region” but this process has now become infinitely more difficult.

If you change your region on Steam, you need access to the local currency and a verifiable billing address to authenticate the purchase. Not only that but Steam can begin to question you as to why you have games in your library where the versions are from different regions.

Most other companies typically just don’t sell their games in regions their services aren’t currently in.