I think usually what I've seen with this sort of discussion is that the question ultimately comes down to how "necessary" some of the elements are. For example, a moment of intimacy can go a long way for character development, and taking the time to describe it can add a lot for imagery and emotional depth. Shock body horror can really emphasize the emotional pain the characters would probably feel, whereas only the implication would save the reader from the punch and make it harder to sympathize. On the other hand, there's works where you feel like the sex is just thrown in, the cruelty on display unnecessary even when put in a thematic context, etc.
Of course, the discussion becomes more difficult once the line of "necessity" starts to get blurry -- different people hold different standards, different people see different lines the story could've taken to achieve the same emotional result, different people just flat-out do not like seeing these themes in a story to begin with, etc.
My own personal view is that the author can do whatever they believe is right for the story, regardless of how "necessary" or not it might be in the long run. I think, in the long run, the fact that you're going to have people both praising and questioning the inclusion of some of the more risque elements is what makes discussion of people's works more interesting, personally. Conversely, if a reader is not comfortable with the inclusion of the elements -- it is what it is. People have a right to enjoy the stories they read, and if they don't enjoy a story, why should they brave through it?
anyway, something something, promotion, something something