Steam are.. wonky. Games like Evenicle got a pass despite having a rape-heavy content, while it's sequel, despite being tamer in term of content, are stuck in greenlight hell. They're very inconsistent. Even if we not talking about H games, this
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for example, an M rated game of a Vita port just simply got rejected recently.
If Eroge VNs with R18 content shipped in the base game already got a very tight screening in the first place, What are the chances of a nukige with "taboo" content such as lolita,etc will make it in?
Packaging the game as R13 to get pass screening while putting their patch outside steam is a very safe move, because it no longer bound by steam rules since it already counts as "modding."
If I want to mod some of the most fucked up porn mods for my Skyrim, Steam can't do shit, nor do they care. But if Todd Howard put a little sex easter egg in the game, it might actually enrages the big Gaben.
Yes, I'm over exaggerating a bit, but you get the point. They're like the opposite of Twitch. If you stream a game with sex scene, as long as it was part of the game, then it's allowed, but if you mod a pixel of a boobie, you'll get banned. It's stupid, but simply when in Rome, do as the romans do.