Lore Spoilers:
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In the Worm universe, almost all parhumans (people with superpowers) went through major trauma before their power manifested. As a direct byproduct, many (if not most) super villains were abused before becoming abusers.
One main (ish) character was also groomed from a young age and was a victim of pedophilia from around 10-13 years of age. There’s a brief mention of a gang using sex slaves.
Several instances, yes. Includes a human being disassembled with nerves strewn out across a room while still alive in tremendous pain. Another person with tons of extra body parts. Another person who is slowly turning into a giant tentacle monster.
Quite the opposite, actually. The heroes in this book are a very blatant metaphor for police, and they're shown to be incompetent in many ways, and repeatedly fail/let down the main character, leading to her joining the villains.
Skidmark's dilapidated mall's party and even his power are very strobe-like. Moreover, Gray Boy and Ignis Fatuus are walking strobe effects on their own. Although this is a book, so it probably won't cause any strobe-related issues to readers.
A group of thugs is shown shouting homophobic slurs at a person that they had recently assaulted. It is to note that the person that they were assaulting was not LGBT+.
It's worth adding that the neo-nazi group in the story is very presented as being evil/wrong, and the author clearly does not support or promote their their viewpoints.
There's a character "Circus" who's ambiguous (implied to be genderfluid)
Direct excerpt from book:
“Wait, Circus is a guy?” Regent asked.
“Depends on your definition of guy,” Tattletale said. “If you’re talking biological or what Circus identifies as. Not that I have it pinned down; I can’t tell if you’re a guy posing as a girl when in costume or a girl who poses as a guy when in plainclothes.”
The protagonist is implied to have consensual sex at one point while exploring their relationship with another main character. And it would’ve definitely been their first time. So, yes.
There's a fade-to-black if characters participate in sexual activity. We know that certain characters have sex, but we do not see any scenes of it happening.
Largest potential trigger of the book behind bugs. There is more blood/gore in this than, more than likely, any other media you are likely to consume. It doesn't feel like "too much" if you're okay with it, but if you're not okay with gore, this will very likely be quite disturbing.