As far as I can tell Paypal is still working for NSFW purchases on the site in general. The most recent sale of the game was about four hours ago, roughly the same time you made this post. There are no other ways to buy the game on Itch, though supposedly the people running the site are working on the problem. If you're able, you can pledge to the SubscribeStar for a single month at $10 and message me there, and I'll be happy to send you a copy (you can cancel after that so you don't pay for more than the first month). But that would require a credit card SubscribeStar approves of.