the other comment is talking about a scene in the anime. In the game he has straps on the operating table he uses to keep her in place.
There is no sexual assault in the game
A minor antagonist who is about 13 years old is killed. It’s not graphic. The protagonist can also be killed in chase scenes, and is shown bleeding out. This causes a game over.
There are instances where the player has to hide in small boxes/lockers, or crawl through a small vent. These scenes are all fairly brief and the characters aren't particularly bothered in them.
Only in the prequel manga. There was a wlw character that died in the hands of one of the game's antagonists. Everyone else doesn't have a canon sexuality so who knows.
There are also mentions of a puppy dying in a flashback, but this is not shown on screen.