But isn't the opt in system is as presented in Consent in Gaming equating those things? The RPG Consent List at the back of the booklet lists natural disasters (flooding?) in the Mental and Physical Health category sharing the space with sexual assault, genocide, and heatstroke. (Seriously, does anyone think heatstroke belongs on the same list as sexual assault, self harm, and torture?) From my point of view, it goes without saying that I'm not going to introduce sexual assault into a game without talking about it first. But not in a million years would I think I had to worry about heatstroke being a source of trauma in a game where we're routinely hacking off limbs and searing the meat off of bones with fireball spells.
Pretty much that's one of my complaints in a nut shell. Some of these things are not like the other.
In game sexual assault, particularly backed up by the possibility that the person doing it may be 'getting their rocks off' is a totally different class of things than "things that might trigger a hypothetical person with serious emotional issues related to that thing". Like you, I think it goes without saying that rape isn't going to be a focus of play, and if it ever were to be a focus of play then I'd only start a story line like that by saying, "Hey, so I'm thinking of a game which involves some seriously wacked adult situations, like rape, and I'm planning to handle that as tastefully as a I can, but I recognize that this is serious topic of general distastefulness to pretty much everyone."
I am never going to think, "I can't introduce scenarios with intense heat because somewhat might have had heatstroke and that was intensely traumatic experience for them." And if someone were to actually say, "That heatstroke experience I had was so intensely traumatic that anything that reminds me of it tends to cause psychotic episodes for me.", I'd probably be like, "That sounds serious. I'm not qualified to provide that sort of therapy and emotional support. Role-playing is often used as part of a clinical therapy treatment, and if you are having such serious emotional issues telling fantasy from reality, I'm not sure I'm comfortable engaging in recreational role-play with you. However, if you are willing to tough it out and risk it, then I can say that I promise to give you a supportive and safe environment. I can't however promise that you won't undergo stress at times, and if you need to take a break, I'd totally understand. Your call."
But you know what, that would be a really unique and unusual circumstance I think. And really, most people I know who have had legitimately traumatic experiences don't have that problem with getting triggered easily in that way, and frankly I would not encourage anyone to expect that just because they have had traumatic experiences that being actually triggered is in any way normal, expected, or healthy. Stressed, sure. Feeling intense emotion, sure. But most adults have coping mechanisms to handle intense emotional experiences, and some fraction of my players are playing precisely to engender safe but intense emotional experiences of various sorts which would be rare and entirely unsafe in real life - which is pretty much the same reason many of us read novels or watch movies.
Intense sexual experiences are however generally off limits at tables I've played at. Or really, sexual experiences at all, precisely because - aside from often being distasteful - that tends to blur reality and fantasy in a way that makes a social situation not feel safe.
But again, we are in perfect agreement that 'sexual assault' ought not be remotely in the same category. It not only trivializes the issue, but I think would tend to creep out the majority of my female friends to see it treated like that. It sure as heck wouldn't feel 'inclusive'.