On the poster question,
Does anyone else find it extremely weird that Faith depicts the gunt as a woman. I'm certain that the gender change wasn't just some "lol so random" joke, but a window into Faith's psyche where she truly sees the gunt as a woman. I wouldn't be surprised if Ralph is into being made to wear women's clothing, just like how he was made to wear some hideous dress in the poster.
During streams Gunt's personality is very catty and bitch like, making him manifest the most toxic aspects of femininity. Gunt's sissyfication was fueled alcohol which is very rich in phytoestrogens and he most likely doesn't filter his water.
There is also the factor of childhood trauma. Gunt was probably molested by his close relatives making him this fucked up, splintering his ego and making his child brain cope with the trauma by assuming a new identity. Maybe the little Ralph tried out his grandmas dress and really liked it. Substance abuse and obesity are also usually linked to fucked up childhoods.