I really don't read stories like this because the plot is just r@pe but I can understand reading for suspense because this is a HORROR story. If some of you are fetishizing and romanticizing this you are a weirdo get some help....
Don't care.
Minus the r@pe and Sa the author really encompass (ironically) various unconventional themes you wouldn't usually see in a manga like this. Questioning how society understands relationships, what that means/looks like. I think the author's not only exploring gender dysphoria though. Constantly the motif of defying gender and gender roles is very refreshing but, it also very unique in its own way encompassing a lot sexual shame as a driving force. "Lust and Desire" is not been shamed innately because we see Yo and Kei engage with it in a unshameful and fulfilling way. But rather its the Lust and Desire that makes one unclean or feel shameful when performing it under the crude restrictions of gender notations and engagement between "man" and "women". The un-fulfilling release from orgasming not feeling genuine to yourself becomes shameful and "dirty". A act of constant addiction. I can see how horrifying that feels the way it's visually described through the manga makes it even more unbearable. This was beautifully written and drawn regardless honestly a perfect example of exploring the social dichotomy we call "gender and sex". Definitely a good read.