If you lose to a Wyvern [Random enemy encounter.] and they're a female there is a chance they'll Unbirth you, There is also an NPC you can take advantage of as well named Christy who's giant dragon butt can't get through a doorway, If you talk to her too much after saving her your character slips up and eludes to their abuse of the situation and you get Unbirthed by her too turning you into a dragon... This isn't a game over.
Flexible Survival has lots of fetishes like Latex Entrapment, Inflation and even Male-Pregnancy, If memory serves the M-preg content has it's own dedicated area in an orc fort! It also is the only game I know that has a bunch of "Live with it" situations where you're allowed to fail a situation so badly it gives you a permanent consequence and heavily effects the ending you'll get... But doesn't actually end the game.
I give it a solid 8 on the crazy scale, Heavily recommend to any Xenophile. Their is like 0 Non-Xenophile content but one may enjoy the wild ride. [Also heavily recommend the "Researcher" gameplay type as it allows you FAR more control in what TF's you take.]
My current 10 on the crazy scale still being "Demon Angel Sakura" [Chapter 3 and up.] the only game I know where it is mandatory to get blasted out of giant fairy ass to giant fairy ass just like Donkey Kong barrels to complete some levels.