On a whim I reached out to PQube to see if I could get a comment from them in regards to this matter. All I received from them was a reply that they would not be talking about it any further and to see the Tweet(which I linked above) they made about the issue. That seemed like where this story was going to end. Aokana was being censored on the PS4, PQube and Sony would not go into details, PS4 owners would be forced to played a censored product if they bought Aokana.
That was the end of it until I received a DM on Discord from someone who has experience dealing with Sony's censorship policies. This person, who wished to remain anonymous, let me in on some things we have long suspected. First and foremost, Sony does in fact issue an ultimatum on publishers, either amend your game or it will never be released on the PS4. I know this seems fairly obvious but as I said, we never had anyone come out and confirm this was the case.
I was then told that Sony often instructs publishers to not reveal what was altered or removed. This is a blatant attempt by Sony to obfuscate what is going on and to trick people into purchasing a censored product. By the time customers know they have a censored product it would be either too late to return it or they have invested too much time into it to want to return it. Sony gets paid and customers get screwed.
Now, the exact policy Sony has is actually exactly what you would expect it to be. "Young looking" characters, male and female, who may be mistaken as underage can not be in compromising positions or touched by the player in a suggestive manner. On the surface this seems like a good policy. Underage characters shouldn't be sexulized. However, anime has a lot of fuzzy lines when it comes to this kind of thing. Actual underage characters look like grown adults, grown adults look like small children, teenage characters could go either way. With Sony's policy worded as it is, any anime character they deem to "look underage" would not be allowed to be in any fanservice type material.
The most disheartening thing I was told by my inside source was that Sony's American office called all the shots, so no amount of pleading to Sony's Japanese office would reverse this policy. Even boycotting censored anime games will do nothing but allow Sony's American branch to claim Americans don't like anime games and that is why these censored games didn't sell. It seems that Sony's American branch has deemed anime games unacceptable for Western audiences and there isn't a damn thing you can do about it. FML!