Ratings only apply to sexual content. I guess the way she got cut might look sexually suggestive to some people but it still wouldn't qualify for rating:e.
It still is absolutely horrendous and the artist who makes this, well they only make this kinda junk. But yeah not sexual so its not under that. Also why there is a Guro auto blacklist. I just can’t imagine drawing this, since i cant even LOOK at this trash.