The process is fairly simple and all a user has to is to modify two configuration files found inside the ISO file. Needless to say, such an action would require homebrew-enabled PSP.
It would be interesting to see how much will this scandal escalate in the near future. Our first guess is that it won’t even near the previous Hot Coffee issue, when sexual content was included in the Grand Theft Auto San Andreas game. First of all, this time the content is only available to a limited category of gamers.
Second (and rather sad, actually), it’s a known thing that sexuality is currently marked as “more evil” than violence among anti-gaming activists.