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Oh yeah, some killing animations can be gory like the killer Hag who bites her victim and then thrusts her claws to its stomach and eating it.
Mostly slashings.
In terms of other player toxicity, you have to be a total nihilist and feel no remorse to them.
Meg's and Laurie's though, you can feel the pain.
There are sounds like being hit with a chainsaw or hooked, which to me sound like squirting ketchup out of a bottle. There's screaming, but it's just that screaming.
There isn't foul language unless you count usernames and stuff people type in chat. You can dodge end game chat easily by just leaving, but if you play survivor then you have to see it. Honestly language is probably your biggest concern when it comes to this game and "Is it appropriate?" Any bad thing you can say, I've seen it in chat or in a username.
It's the community itself that's the real problem. But that can be said about the entirety of the internet itself. There have been people who would add me only to give death threats, or threaten my family, or say they have my IP and were gonna hack me, simply because I beat them. Of course these are nothing but empty threats but they could seem real to someone not used to that kind of thing.
If your kid can't handle being bullied or insulted, I would highly advise to not buy it for them at all. If you don't know if they can or not, then I would still advise to not buy it for them. If they know enough to take the insults more as a joke or in stride and laugh at people trying to threaten them and know to not take it seriously, then it should be fine and may even be more entertainment value, to be honest.