Game design considerations of phobias

There was a twitter thread a few days ago that ultimately got deleted because too many people made uncharitable reads of it. The underlying idea was a bit interesting though. I wanted to riff on it, and twitter's not a good place for that. So here's some unorganizeed thoughts.

The underlying idea was just wondering whether games that have well-known phobia-associated things in them (e.g. spiders) explicitly consider whether their game needs to have such elements, or could use something else.

Despite a recent post, I have done some game design.. and such a thought never entered my thinking. But I'm not a designer. Would Romero consider it? There's a spider in Doom. It didn't need to be there. Did he consider it in the context of arachnophobia existing? I doubt it... Others in the threads who have knowledge one way or another have brought up cases where it was considered, though. e.g. apparently Guild Wars 2 cut out a spider mount explicitly because of players with arachnophobia existing.

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