In the more than a handful of occasions where creators were forced to change so far, a few went the "replace word" route and to be honest, it does not really work that well.
For example, you would need more than one option, as immersion wise its pretty harsh when you only ever hear the word Dad. No change ever, always the same, no pet name like changes, no Daddy.
Thats why I think the patch/mod way is the way to go, IF the creator does the mod/patch, and already has the story set up to work with it, meaning, they have innuendos and all that stuff in game already. Then just drop your patch/mod somewhere, and enjoy the thankfully still remaining anonymity when working with the internet. Its basically a underground way, which limits some kind of advertising, and would require a bit of a set up time first, but the people like/want/pay for the content that has been seen, so they might be lenient there.
The problem remaining (well one of them) is that the most tough conditions apply to new creators, as most probably dont want the hassle, dont have the playerbase, dont know where they could advertise the real version they create.
The only problem I see with that is how you'd both inform your players of its existence and keep it off of patreon so that they don't stumble on it. For instance, you couldn't launch a site that links to your patron, because they'll catch that, you also couldn't put the link to a site on your patreon, because they'll catch that. Essentially that limits people to places like this for their NSFPatreon releases. This would be fine for you and me and a couple thousand others. But it would never be enough. That said, if the mod is built into the game every potential player will now know that they can expect these genres from you in the future, they'll be interested in your games because of the taboo content in spite of the fact that you don't advertise it.
That is the most nefarious part of this. It limits our reach. I enjoy lots of games and content, but the intimacy and taboo nature of incest seems to be my most gracious trigger, so I look for it in games I download, and intend to include it in what I create. Now creators who will flout the rules will have a hard time reaching their audience, unless we somehow find a way to create a new slang term to get it past the filters. That is why I think the best route is to include it in the base game, because unless you already know about sites like this one, or are already following a developer, the only way you're going to find the content you really want is if its a choice in the content as provided.