The ratings system doesn't really matter for people like us who are exposed to pretty much every game and know enough about them to form an opinion on them. I don't have kids, but it would depend on how mature my child was. I was playing the GTA games when they came out (I was 11 I believe when 3 came out) and it never bothered me. GTA IV is a lot worse than any of the previous ones, though. Plus, there are worse games out there than GTA. I don't think I would let my kids play Spec Ops: The Line until they were close to the age. Probably not horror games like Amnesia or the early Silent Hill games, either. Those are few and far between, though. Things like Assassin's Creed, Gears of War, Halo, Call of Duty, Resident Evil, God of War, and others I wouldn't mind playing when they hit around age 10 or so. If they're old enough to be able to handle the mechanics of those kinds of games, they can handle the level of cartoony violence that is in them.
I actually struggle to think of games other than those examples that I wouldn't allow them to play. Games can be violent and sexual, but with few exceptions, games haven't reached the level of maturity that other mediums have that I think is too much for children. Most games, kids will look at and find the level of violence funny or gross, not disturbing. It's probably just because I had just finished it recently, but Spec Ops is one of the only cases where I could see children having a hard time dealing with it.
But like it was said earlier, if kids want to play something, they'll find a way to do it behind our backs. I never had to, but I know friends who did and they were able to do it. It's not hard.
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