Snats has stated multiple times the only person doing the ass pounding is the MC. Honestly I believe him. Fuck 17mokeys with that shit though, still bugs me to this day 'Oh BuT It'S a ClIT!111"
Yeah, that dude is the worst kind of dev. Straight up just constant gaslighting and lying, any time anyone tries to ask him questions about his games, he just deflects or gives non-answers, keeps reusing the same assets to start new games instead of continuing his old ones - or taking months to release 30 seconds worth of content, at best - throwing un-tagged "three letter tag which shall not be named as it has no place in this wonderful harem game thread", and just straight up denying it when confronted about it, answering anyone asking about "is it male on futa or futa on male?" with simply "It's a futa game" as if that answers their question, because he clearly doesn't understand that not all futa fans are into both (and some are exclusively into one or the other), and straight up having the start of the game seemingly include opt-out/skip scene options for the futa scenes, only to later just force the far more egregious ones on the player anyway, making that earlier choice entirely pointless.
Snats is just slow, which sucks, but at least he seems to be still doing everything he has said in terms of content. The chances of Snats randomly pulling a 180 and having a futa or one of the femboys trying to top the MC is basically zero. MC has the magic dick, so everyone wants it, even the futas and the femboys (if you have that turned on).
As for the actual update, kind of sucks that it was interspersed with the previous hospital update, so you had to have an old save from the end of Hell to even actually enjoy it, but I did find it was way better now than it was originally. Too bad it took so long to get to this point, since the original version of this "first half" of the hospital section was SUPER lame before. It was better if you had futas/femboys on, since Lars was a huge chunk of the sexy content, but without that on, it was basically all just Tomoe scenes when you were sleeping, before, which sucked, at least now you get all the new lars and Tomoe scenes, and all the sexy family scenes, plus the scenes of the other patients pleasuring themselves. If this had been what we got a year ago or whatever, it would have been great, but waiting this long definitely feels bad. Hopefully the wait for the next part isn't as long, but with Snats, I've come to expect long waits.