Itch only has yes or no for the sensitive question. It has no granular distinction just how sensitive or why.
And yes, that particular game, especially with that cover and the topics in the game, even without explicit graphics, is something that I would answer with yes on the sensitive question.
Skirting between M (17+) and AO (18+) is splitting hairs here. Itch's nsfw category is not an official age rating, and trying to be technically sfw is not helping the case, should staff have made a decision here. For all we know someone reported the game as being offensive, because it was not marked as adult.
