There's times where I've been hesitant, but most people my age (early twenties) seem to get it more than older age groups. Sometimes I'll just say fuck it and talk about it if the conversation is going that way. If someone is a dick about it then, hey...I guess they're dicks?
This may be unrelated to the reasons you feel so bad OP, but this can apply to anyone out there who might be in a similar situation. I'm talking about being unhealthy.
If you're fat--which many of us might know doesn't exactly fill you with confidence--go out there and fucking lose that shit. I've spent the last year of my life (whilst unemployed) trying to lose weight, and I've lost somewhere between 80-100lbs in that time. I've still got a few months' work left until my belly is totally cut from my body, but I know it will happen eventually if I keep up the work.
I'm finally starting a new job this month too, and with every stone I've lost over the last year I've felt that much more willing to go out and there and start dating again. I haven't yet, mainly because I'm stubborn and want to remove as much excess weight as I can before I venture out there, but boy howdy do I feel better for it. Some chick called me "hot" the other week--that's probably the first time in about four years.
So again, this may not be related to you OP, but to anyone else out there: get fit. Find exercise routines that work for you, stop eating so much shit and eat decent stuff..and sooner or later you'll be a thousand steps closer to being the person you really want to be.
Most of the replies here are spot on. I can't think of a game that has ever had such an appropriate level of violence, given the world and the narrative events that take place. To call it "gratuitous" is really missing the point; or perhaps an attempt on her behalf to merely be contrarian.
Or, she may not like it, but that doesn't mean it doesn't serve a purpose.