Edmund McMillen's fascination with the themes of death and reproduction in games is continued in The C word also known as Cunt, a collaborative project with Florian Himsl, apparently attempting to discourage anyone from having sexual intercourse again. Players control a male reproductive organ centring around a female reproductive organ through various stages of aging and diseases.

Classic shooter mechanics are used although the setting is rather unusual in games. Damage can only be caused by hitting the vaginal openings. The different stages are called trichomoniasis, amenorrhea, candidiasis, menopause and fistula. From the organ in the centre of the screen sprout various abnormalities that attack the male organ at the bottom. They need to be avoided, shot, and when stuck they can be thrown off by shaking the mouse.

There are various power-ups to collect that restore health, make the penis shoot urine (wii power), provide quick fire (raid rage) or enlarge the size into a throbbing mass of flesh (the woodsman). During the menopause the organ will go to sleep every now and then while the screen is filled with urine, which damages the player's "character". In fistula, the same happens with a pool of blood.

The gameplay is accompanied by the subtle, melancholic track "Care" from Kaada.

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