Every period of history has horrible things going on, to include our own. If you were running a modern-day gritty campaign in a major city, would you excise all references to homelessness, drug addiction, gang violence, etc?
I think this question carries a heavy assumption, based in the word "excise".
Did Ford Motor Company
excise all reference to microwave ovens in their pickup truck ads? No, because they never made such reference in the first place! Similarly, if you never happen to mention a drug-addicted person, because no such person was relevant to play, you aren't "excising" them, because they haven't existed in your fiction.
The world is a very, very large place. There is no way that one GM is going to directly mention
everything that exists. Even the most floridly speaking GMs will draw at best a minimal sketch of the fullness of a world. Some things will be left out.
So, we are quibbling over which cherry-picking to do.
The tribulations of a historical period and its social flaws are, IMO, useful plot devices and challenges. After all, purely fantasy settings general have the threat of war or actual war, banditry, raiding, piracy, terrorist-like plotting of cults and deranged wizards (or even things like the Ruinous Powers in WH or the Shadow of the Demon Prince), and so forth.
Sure. And maybe you're thinking that we are talking about making worlds sweetness and light. I don't think that's an accurate view. We are, I think, talking about avoiding
gratuitous inclusion of such flaws. We are talkign about making what is inluded a
considered choice for specific reasons and goals.
If you really want to use an element, make it a theme, a central element of your game's resulting story, that's fine. But if you don't, you have a choice - include it, or not reference it.
Like, you're running a historical game in Rome. You want to include slaves? Okay. And prostitution? Sure, prostitution existed, so, it is there, right?
But are you going to specifically raise the point that much or most prostitution in Ancient Rome
wasn't consensual? That, sex-slaves were common, and in some periods women who were found guilty of adultery could be forced into prostitution? Or do you figure your players are going to not want to engage with sex slavery, and not want that particular tidbit shoved in their faces when they joke about their characters going to a brothel in your gritty game? Note that going to brothels was a normal thing, expected behavior, if not done too often. Highly placed Romans
* didn't think twice about it.
But will your players actually play that, knowing that every act of going to a brothel in game includes committing rape? Is it really a good thing if they do?
Our tables are not full of detailed historians aware of this. They won't know unless we tell them. So, we have a choice, tell them, or not. If not... well, now we are away from all-or-nothing discussion. We are admitting that there are some lines we won't cross, and we are merely quibbling over where we draw lines, and why.
For those of you who are tempted to say you don't draw lines, let me tell you about some larpers I know, from the "Nordic schools". These folks play by what they call a "two-week rule" - any harm done to another player that heals in two weeks is okay. That's PLAYER, not character. To them, it is okay to give another player a bloody nose, or a black eye, or bash heads against walls, so long as you don't give the a concussion or break the bone. Wounds that don't need stitches are okay, too. Broken furniture is fine. If your characters fight, the players fight and punch each other, and none of it "light contact sparring" stuff. Just don't send anyone to the hospital. All in the name of "verisimilitude", "being real", "gritty", "emotional truth", and all that. Same reasons folks are talking about here.
But, I doubt most of you are saying, "Well, actual injuries are historical, so..." Instead, you draw a line, and aren't having your players actually fight in your game rooms.
*I specify "highly placed Romans" as a bit of a pushback on the "this was the accepted norm of society" fiction. It was the accepted norm of people who made the laws. Slavery was not accepted by the slaves, or you'd not have had Spartacus with an army of 100K people at his back. Forced prostitution was not okay to those who were the prostitutes - only the customers.