I frequently hear people bring up the infamous Fukuro video as a counter to my essay on why Silent Hill 2's Pyramid Head isn't a rapist. I haven't addressed this issue in the past because I actually don't know that much about the video or its creation. But I thought I would take a moment to address this issue. First off, let's watch the video in question (warning: contains disturbing content that may not be suitable for sensitive viewers).
This video was made by a small group of Team Silent members, most notably, Masahiro Ito and Akira Yamaoka, and it was included in a documentary DVD titled The Art of Silent Hill. There isn't really much information about this video on the internet other than speculation. As far as I know, Ito and Yamaoka have never made any public statements regarding its relevance to the canon of the games. When asked about the symbolism of the video on Twitter, Ito responded that it abstractly represented the womb.
Does an abstract representation of the womb have any relevance to Silent Hill 2? Not at all. It does, however, have strong ties to Silent Hill 3. In fact, the Fukuro girl character does make a brief appearance in Silent Hill 3! Perhaps Team Silent already had basic designs and outlines in place for Silent Hill 3 when they started work on Silent Hill 2, and the Fukuro video incorporated elements of both?
Fukuro's wiki page asserts that she was a scrapped monster from Silent Hill 2, however no citation is included for this claim, so I can't verify it. The wiki page goes on [without citation] to claim that Fukuro might have been another representation of James' subconscious (along with Pyramid Head). If that is true, then she may have been scrapped because the nurses and / or Maria may have made Fukuro's role superfluous and unnecessary.
the Fukuro Lady appears briefly in an elevator scene in Silent Hill 3.
In any case, if Fukuro had been planned to be a monster symbolic of Jame's repressed sexual frustration, then it seems even less likely that Pyramid Head would also have represented the same element of Jame's subconscious! Pyramid Head and Fukuro's interactions in the Fukuro video could be symbolic of James' sexual desires being a source of guilt for which he wants punishment. In that case, guilt and sexual repression are still separate conditions represented by different manifested creatures that reinforce each other.
Fukuro's necessity in Silent Hill 2 was rendered moot by both Maria and the design of the nurses. It is possible that at some point during the game's design, Pyramid Head's role was intended to be different, and to be more representative of Jame's sexual urges. This could explain the creatures' visual design and the early cutscenes of him "raping" monsters. But as the game's development proceeded, Fukuro was dropped, Maria and nurses were added, and Pyramid Head's role became more explicitly representative of James' guilt and need for self-punishment as a result of Mary's death.
The bottom line is that the Fukuro video and Fukuro character are not in the actual game. At least not in Silent Hill 2. Masahiro Ito may very well believe that Pyramid Head is a sexually-symbolic monster, and he may very well have designed the creature with its Freudian aesthetic with that assumption in place. But for whatever reason, the scenario-writers decided not to pursue that avenue for the remainder of the game. Any lingering sexual symbolism for Pyramid Head is dropped within a couple hours of starting the game, and his role as a punisher is explicitly stated at the end of the game. At best, sexual aggression is a minor, implicit element of Pyramid Head's design; it is certainly not a defining characteristic of the creature, nor is it the creature's primary purpose.
A similar video was also made for Silent Hill 3, and features Robbie the Rabbit. This video also has no relevance to that game's plot.