I think a lot of games deal with it pretty well, Bioware always has options although sometimes a little forced (Yes, I'm talking only gay guy on the ship in ME3 and that means you hook up). Yet the issues that seems to come from it revolves around the USofA. Pretty sure Japan and the most of Europe don't care. Only the US but when the market in the US is so big, it's hard to ignore. Well, I should say parents of the market. :P
But then I don't care about them, they are the kind of people that buy their 13 yr old children CoD (an 18 rated game).
Hmm, pie.