There are a lot of valid points made in this Feministing post about Grand Theft Auto IV, but I guess I'm going to have to wade into the muck and label myself gender-equality-ignorant by saying I think a lot of the arguments presented are really, really silly.
That GTAIV doesn't offer a "female perspective" or "gay-friendly elements" to the plotline is honestly the biggest one for me. By the nature of Rockstar Games trying to make a realistic storyline, the action is going to be inherently misogynistic. The protagonist is a Serbian illegal immigrant trying to make his way up in the world of a parallel-New York city underworld. I think there are a lot of fields where gender and sex-orientation equality have made vast improvements; urban organized crime isn't exactly one of them. (For the record, Rockstar's previous game was last year's Bully, which does allow the protagonist to choose sexual advances toward both genders for various advancements in the plot)
The argument about violence against women is also curious. The major complaint here seems to be "you can kill strippers" and "you can kill hookers." This is technically true, in that you can kill everybody. While there are missions and objectives that are central to your character's interaction with various characters, I've seen no reports or reviews of the game indicating that specifically injuring or killing a prostitute is a play requirement. Yes. You can kill hookers. You don't have to. This also applies to men, children, animals, and an infinite number of other elements in the game.
That doesn't dispel the main argument about the game though- clearly, GTAIV is misogynistic. So is A Clockwork Orange. How you respond to that movie and whether you choose to view it or not is completely up to the individual. But suggesting that either the game or any movie "could have been done differently" is pointless. This is what the creators wanted to make.
None of this suggests I don't think a gender or orientation-neutral crime game wouldn't work. (Gabe & Tycho at Penny Arcade had a hilarious discussion in their podcast a few weeks ago about how much better a game Army of Two would have been if the protagonists were gay instead of, well, vile, offensive women-hating misogynists). Nor does it mean I think it's a great game for kids of all ages- I'm behind the ESRB 100% on this, and any parent who lets anyone under 18 near this thing is a freaking moron. But complaining about the game being what it is ignores the fact that, well, it is what it is.
Given the more common use of female characters in video games, GTAIV is in a way almost refreshing in making the misogyny at least relevant. The exploitation of women in the game is a theoretical focus of the storyline and the environment to which your character is attached. That honestly seems far more understandable than the typical fighting game in which the creators claim it's "for girls too" because three of the eighteen selectable players are either a half-naked Amazon with impossibly large breasts or a half-naked schoolgirl with even more impossibly large breasts. GTAIV features elements in which a male character playing a violent criminal can commit violent crimes against women. Bloodrayne was an action platformer which was promoted with digital images of its star character naked in Penthouse. Which of these is really the more unnecessary feature?