Of course it does, years ago there was not such a push towards not having some content.
Take the issues that Rockstar taken with GTA:VC because the Haiti or Cuban community was "offended" by it.
Sex in game ... the only game I seen something close to it was in Mafia (that was not developed by a american company), The Singles and GTA:SA had sex but it was "edited out", when you have M rated games that have sexual themes but refuse to show then ... well its stupid.
Problem with the gaming industry its became just like the movie industry, thing are done to please certain demographics and some things are simply taboo ...
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Sex in Duke Nukem?