How can folks rate this so poorly? IT'S GOOD. Easily an 8.5
Sure, sexual violence and mutilation is a hard pill to swallow, but the characters are vivid and thought provoking, while the story and their interactions are enthralling and visceral!
I myself am in the LGBT crowd, so I can tell you right now that a gay person is NOT a trans person - and this manga actually gets that right!! From Japan, that in my mind, is incredibly rare. Yes - what s/he does is stomach churning, YES it's disturbing - but that's how people with gender dysphoria *actually* feel! There's a reason why untreated trans people have such a high suicide rate, sometimes as high as 70%! This morbid side of the japanese lgbt community is so VERY overlooked in manga, as people tend to take what's in manga as fiction... regardless of its content or social commentary; so the fact this gets more representation over there is a good thing.