About ERSB ratings, anyone feel like the Teen group has pretty much disapeared over the years? I feel like it's just that any violent game nowadays includes moderate blood, getting it insta-flagged as M.
Also, yeah anyone can get a rated M game with no real issues, unless their guardian stops them, but even then they can find a way. In fact, I think I had access to rated M games as a child because my father kept some old M-rated shooter games in our gaming cabinet, but I never tried them. I think I still have them, actually.
I'm not sure if the ESRB has gotten more sensitive (it's hard to go up from where they already are). I think developers and publishers realized that in practice most teenagers (and younger) will buy and play M-rated games anyway and only the strictest parents actually care anymore. Also, modern technology allows for blood and gore to be shown in more detail, and generally the ESRB's thoughts on violence seem to be that "more realistic graphics = violence is worse".
Back to that first point, though, I personally think video game ratings are good for younger kids but there's not really much point to difference T and M anyway. Most teenagers deal with more sex, drugs, and language just going to school than they'll ever see in games, and literally all media seems to have its share of violence these days. There's not much point in controlling how much they'll see if you're only doing it for one medium.
Really, the ESRB's ratings based on violence, unnecessary as they are, are pretty benign. The real problem is one they share with society as a whole, which is that sexual content is considered worse than violent content. There's the old quote that only 2 or 3 games have gotten AO ratings for violence and language instead of sex - Manhunt 2 and, recently, Hatred - I think there might be a third but I'm not sure.