But it's not a replacement of any other scene. It's an entirely new option specifically added by gore setting being turned on.
It's not an "instead of what you would normally get" deal either, there's already options to be cruel and even kill people in vanilla game.
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Edit: Man, with what a toothless cuck simulator CoC2 is, people really forgot how extreme the original game could get at times. Lmao.
Edit2: Also, I think I get now what you were implying with this sentence:
That that was a sex menu from interacting with an npc, but you are very wrong. It's not an NPC, it's a generic and very fucking annoying (because she eats up random encounter slots like crazy) enemy, with only interaction being post-combat rape.