No, but realism is a dumb reason to argue against not having that stuff in a game.
And half her point is that there is no exploration of real themes; it's all just shock value nonsense.
The argument shouldn't be about "realism", both sides are just rather confused (or purposefully obtuse in attempt to make a point, take your pick). It comes down to using themes to live up to an established fantasy/ideal. Reality does come into play in that all fantasies are based on what humans have experienced in our world and shared with others, although that is also influenced by other fantasies/mythology. When fantasies make a break from reality, the ideal likely remains the same, just exaggerated or maybe occasionally subverted as an attempt to add spice. (We could say the action movie hero (if not the mythological warrior hero) is predominately male because that ideal is based on the male soldier/fighter who has been exaggerated into something unrealistic and when we see the exceptional female action hero, it is a subversion of the male action hero, not a fantasized female soldier, to spice up the original concept).
The imagery associated with the "wild west", based on both the history of the region and centuries of media that has colored it, vividly includes saloons with prostitution, as an example. Now developers could stray from the bits and pieces Person A dislikes, but what would be their motive? I mean besides "because I don't like it." Reality/society has planted this image in their brains and they want to see it come to life as an interactive world, a fantasy in its most immersive form; the "unfortunately realistic" historic elements can be deeply tied to the image and come naturally. Diluting the ideal can be difficult (or at least, not come to mind) for two reasons: first, the ideal is likely powerful and familiar enough to be desirable (hence why people go out of their way to make these things uniquely named "westerns"), and second, their initial motivation/passion to bring that ideal to life is likely opposed to the idea that it needs to be "fixed" - that is changed for reasons that exist outside an attempt to make the fantasy more satisfying and immersive (e.g., more positive representation of women characters in gaming, to offset a theoretical harm being done). Subversion can come naturally though, because some dilution can also be interesting, depending on tastes.
Understanding that, the "inventory mechanics and so aren't realistic!" argument is flawed for at least two reasons.
1. The breaks from reality in the form of game mechanics are not necessarily opposed to the ideal. A cowboy who can slow down time to get in precise shots is unrealistic, it's more like film than real life, but it in every way lives up what the fantasy it is trying to achieve. Things like inventory systems, loading screens, non-first person camera angles, badass kung-fu zaniness, etc., fit in the fantasy (or atmosphere), supporting it, enhancing it, or working as a necessary evil. The same is true for the themes (visuals, sounds, etc.) used to make the ideal, as it was taught, come to life. On the other hand, choosing not to use an established theme so that the material may be more socially acceptable has an entirely different concern.
2. The rules of a videogame not being acknowledged in the fiction of the game's world has a different kind of relationship with realism from depictions of humanity and society in that fiction. This should hardly have to be stated. In this case, one hardly is depended on the other (it would also be rather silly to demand the opposite scenario). A game that is unrealistic (and for that matter all videogames must be at least somewhat unrealistic, as us arbitrarily recognizing it its own little reality with its own rules is what makes it a videogame) reserves the right to be realistic and non-realistic and developers can no way be found hypocritical in only partially demanding "realism", whatever it may mean to them, in completely unrelated elements.
When pressed on this, the argument can be understood along these lines: "If you can bend reality to make this fantasy how you like it, why can't you bend to make it how I like it?" even though they may be directly opposed from the start.
Additionally, themes are not owed "exploration", much like colors, shapes, and spooky noises are not owed "exploration". What is more likely being said is that they are owed "explanation", which is another way of saying "certain themes should be off-limits unless you use them tastefully" and "tastefully" being a deceptive way of saying "how I like it".
This was the only argument I was interested in tackling, mainly how it was stated here, so my apologies if it looks like I'm ignoring the context of the video.