No piercings and tattoos yet, as far as the lesbian stuff is concerned: Well, yes, kinda? The issue - as of now - is that the protagonist doesn't really act according to your choices, so in my personal opinion I wouldn't say there is a way to play as a lesbian, since the protagonist will fawn over - and interact with - male characters even if you pick opposite choices. It will probably be possible to avoid having sex with male NPCs, but how much that matters when your character is constantly internally monologing about how hot she finds this or that guy...that's up to you.