Have no fear. M-ratings exist for that same reason. You generally don't have to censor things. The ESRB rated Halo: Combat Evolved M18+ because Cortana looks vaguely like a woman, Sergeant Johnson does light cursing, and there's blood, and that's probably the tamest M-rated game I've ever seen. I'm pretty sure the ESRB gives X-ratings if games get a bit *too* graphic. If America has to censor anything like this, then the game probably shouldn't exist, let's be honest.

Postscript: Don't blame the ESRB if it gets censored. Blame the woke snowflakes who are unable to fathom the capability if someone who's old enough to play a game that would apparently need censorship to differentiate between fiction and reality. I, for example, play DOOM, one of the bloodiest and most violent games known to man, and I'm actually pretty chill and I normally exude kindness.

Another thing i just forgot to mention, sony also doesn't allow most of their games, and on steam they had to remove a certain feature on Mary Skelter 2. (Nintendo kept it for some reason so i got it on there)