Fifteen years after its release, Atlus's 2011 title Catherine continues to be discussed for its ambitious narrative and unique gameplay. More notably, the game served as an early, though imperfect, exploration of transgender representation in video games, a topic rarely touched upon at the time.

When Catherine first launched, Atlus was not the mainstream developer it is today, known primarily for its work on the Shin Megami Tensei and Persona series. The studio sought to break new ground with Catherine, focusing on mature themes and adult identities. This ambition led to the creation of one of the few transgender characters in video games of that era.

The game tells the story of Vincent, a man content with his bachelor life until he meets Catherine, a seductive woman who disrupts his relationship with his steady girlfriend, Katherine. This encounter plunges Vincent into a series of increasingly terrifying nightmares. The gameplay cleverly mirrors this dichotomy: players navigate Vincent's daily life, making choices about his relationships, which feels like a natural extension of Persona's social simulation mechanics. However, the core gameplay loop unfolds during Vincent's nightmares, where he must scale an ever-descending tower of blocks in a puzzle-solving format. This structure serves as a compelling inverse to the Persona series, where the bulk of the gameplay occurs at night.

By moving away from the high school settings of its previous titles, Atlus was able to delve into more complex adult themes such as infidelity, alcoholism, marriage, and the struggles of adulthood. This thematic shift also allowed for the depiction of characters not typically found in a high school narrative, such as Erica, a waitress at the bar where Vincent and his friends frequent.

Erica, presented with a decidedly feminine appearance, offers a neutral, often flirtatious, ear to Vincent and his friends, providing a respite from the emotional turmoil. However, the game hints at a secret she harbors: she is transgender. This reveal, however, is handled with a degree of cultural insensitivity that would be considered problematic by Western standards.

As the narrative progresses, Vincent's friends begin experiencing the same nightmares. Erica initially attributes these to a "woman's wrath curse." Yet, when she begins a romantic relationship with Vincent's friend Toby, she too starts suffering from the nightmares, which are exclusively experienced by men in the game's lore. Subtle clues are sprinkled throughout, but the full extent of Erica's past is not revealed until the "Katherine True" ending. In this conclusion, Toby discovers Erica's history, and the game explicitly refers to her deadname. The "Full Body" version of the game further complicates this by featuring a detransitioned Erica in flashbacks and an alternate ending.

This portrayal, while not intentionally malicious, highlights a significant cultural divide between Eastern and Western perceptions of gender and identity. Japanese culture has historically embraced a wider spectrum of gender and sexuality compared to the West, where transitioning often implies a societal expectation to medically and physically conform to a gender role to be accepted. In Japan, gender expression can be more fluid, with cross-dressing and presenting as a different gender often sufficing without necessarily undergoing medical procedures. This is partly influenced by legal frameworks, such as a 2003 law requiring specific conditions for legal gender change, including gender reassignment surgery, which itself had prerequisites that complicated the process. This societal context may explain why Catherine's narrative focuses on Erica's past rather than solely on her present identity.

Despite its controversial elements, Catherine is notable for tackling mature themes with sincerity, never trivializing the issues it presents. It offers a glimpse into Japanese social dynamics and contrasts them with Western viewpoints. The game's well-intentioned approach, even with its problematic aspects, allowed Atlus to venture into uncharted narrative territory, resulting in a complex and enduring title.