BoEF is ... a real can of worms. It has some things that are tasteful and respectful, some that are balanced, and some that aren't based on horrible puns. There are a few things that are all three of those at the same time, but they're kind of hard to find.

I will say that I've used exactly one thing from BoEF in a "regular" game, and it worked out extremely well. My wife wanted to play a Gnome Artificer whose thing was crafting magical jewelry. BoEF does have a table for alternate magic item slots, based on types of jewelry, that's extremely sensible and balanced just as well as the regular item slots are. More of a fluff change or re-skinning than an actual new rule? Maybe, but it really surprised me there hadn't been anything else like it published.

For the more NSFW stuff, like everybody else has said, do not spring that on your players without asking first. You do not want to be yet another entry on the "creepy D&D experience" pile.