This is based on opinion. Please don't list it on a work's trope example list.
Tear Jerker / Katawa Shoujo
"S-sorry... f-for making you w-worry."note For context, this is after Hanako suffers a panic attack during class and is left emotionally distraught.
His Act 1 bad ending is one, even if he had not drunkenly fallen to his death. He walks around the festival, lonely as he notes that none of the girls he met in his first days are available, and never emerges from his state of depression and bitterness.
For that matter, try to imagine the aftermath. Kenji is crazy, but I sincerely doubt he's going to take Hisao's death all that well, especially considering it's more or less his fault. And that's assuming he doesn't get held responsible.
Not to mention the reactions from the girls. Especially Emi and Hanako, who have experience with losing a loved one. OK, They weren't that close to Hisao yet, but Emi and Hisao have been running together while Nurse told her to keep an eye on him, while Hanako is scared shitless of making a new friend but tries to anyway. Then suddenly Hisao falls off the roof and dies. That's so not going to help them deal with their traumas.
The discussion after the exams, where she explains why she can't rely on you.
She leaves her mouth close to my ear, as she confesses this one thing to me.
Emi: Because, Hisao. I've already had everything I knew ripped away from me once. I don't know what I'd do if it happened again. ... So I can't rely on you. Or the Nurse. Or anyone else. Just me.
The Bad Ending. After Hisao's unfortunate choice of words gets him thrown out of Emi's house, and eventually not telling anything about it to Misha after she questions Hisao about it, Hisao confronts Emi about the whole issue and they break up and never talk to each other again according to Hisao. Particularly painful after seeing how well they got along during the whole route up to this point, as well as Emi's complete lack of hesitation at calling things off.
The scene with Emi opening up to Hisao, a week after she threw him out of her house for bringing up a touchy issue.
The conversation in the graveyard counts as well. "Eight years ago today, I lost my legs. And I lost my father as well."
Hanako is basically a walking tearjerker. She's horribly scarred from a fire that killed her parents, one of which she presumably watched die before her very eyes, all her friends she had before the accident became her bullies and she was consistently bullied and excluded throughout elementary and middle school. At the orphanage in which she lived she had to see most other kids get adopted eventually, but was never adopted herself. Good God is that depressing.
The reveal of how she came to be scarred, and why she's got (some of) the psychological issues she has.
Hanako:The fire happened when I was eight years old. It was night, and I was sleeping when it started. I... curled up into a ball... when the fire swept over me. My mother... tried to shield me. Th-that's the only reason... I lived.
Hanako's panic attack is quite upsetting and rather uncomfortable to watch, especially considering that everyone involved tries to make things better after the inital faux-pas, but it simply doesn't work. The next time you see her, she's curled up on her bed, alone and weeping (see the page image).
Hanako's Bad Ending. It's shocking enough to see her suddenly lash out at you, but what really drives it home is the fact that it's very easy to think the choices that lead to it are the right ones. Most of what Hisao's done to try to help has actually been hurting her, and her rant against Hisao's insistence on protecting her is entirely justified. This one comes as a massive What the Hell, Player? moment, and forces the reader to consider whether or not they went down Hanako's route just because she is The Woobie.
Hanako: Get out of my room, get out of my room, get out of my room...! Leave! I'm telling you, go! Hisao: B-but... I was just trying to... help you... Hanako: I know I need help! I know I'm broken! I don't need you to tell me that! Hisao: I never said you were broken, or anything like that! Hanako: It's written on your face, it's written on Lilly's face, it's written on everybody's faces! I see a therapist every week, Lilly dotes on me as if I were her child, and now... even you! Nothing's changed, nothing at all! I hate Lilly, and I...I hate you more than anyone...!
To pile on the tears, after that outburst, Hanako's angry face turns into a tearful one, as if she realises that she shouldn't have exploded like that.
Her Neutral ending isn't much better. She and Hisao do spend a much quieter evening in her room, having dinner and playing chess while making small talk... but there's a lingering sadness in the whole scene. Specially as it's implied that, while remaining friends, Hisao will keep to put his needs aside for hers, which will eventually turn their deal into a self-destructive one. Who's to say that Hanako won't eventually snap at him...?
Lilly's neutral ending is definitely this: Lilly's storyline gradually becomes more and more depressing, as Hisao starts to think his relationship with her and indeed his entire experiences at the school have been All for Nothing as she leaves for Scotland never to return, eventually culminating in the "Farewell" scene before immediately cutting to credits.
However, in her good ending, Hisao refuses to accept her leaving and has a Race for Your Love moment where he chases her out to the airport the next day, desperate to see her just one more time, but just as he finds her, he collapses to the ground, suffering from a major heart attack as she walks away. The scene at this point really does resemble a bad ending, really driven home by the fact that Hisao, and possibly the player, actually believes that he's going to die there and then, taking one last glimpse at Lilly as she leaves forever. However, this is luckily turned into a purely and entirely heartwarming moment by the end of the scene, with one of the best uses of Chekhov's Gun in the entire game.
Rin's first H-Scene. It doesn't help that you find her alone on the floor, sulking and a complete mess. The dark background and music only makes things worse. It feels like you are destroying her in some way while you two have sex in her depressed, almost insane state. The bad ending you can possibly get after that is utterly soul wrenching just to top it all off.
Rin: I can't hug anyone, Hisao. I'm a bad person like that.
Possibly her biggest tear-jerker of all is Rin breaking down in front of Hisao and shouting; "I have no idea what's wrong with me!"
Also, a few moments later in that same scene, Rin crying. Oh my God!... The detail in those tears. Let's also not forget that actually Rin is the only romanceable girl whose sprite includes tears rolling down from her eyes, dethroning Emi's famous Puppy Eyes completely. Then in that state, she let's herself fall in Hisao's arms, crying silently for a while, until she raises again her head to say: "Let me be here for a while. Please, Hisao. Just give me a little while". And this is already in the way for the good ending of her route.
Rin:Hisao? What's the word for when it feels inside your heart that everything in the world is all right?
Shizune's bad end you get for accepting Misha's advances. Oh, Christ. While most of the text remains the same as the Good End which has the theme of accepting graduation, having it change to have the underlying subtext that you went behind Shizune's back with her best friend makes every scene so uncomfortable. And it all ends with Shizune alone, heartbroken, without a friend in the world, staring vacantly on a stoop as you leave, leaving her completely and utterly crushed.What the Hell, Player??! And as one final note, the stuffed cat toy you won her in Act 1 is hanging out of her bag.
And the worst part? Shizune thinks that the reason Hisao and Misha have been acting so distant is her fault, when you were the one who went behind her back!
Perhaps the worst part about all this is that of the five girls and Misha, Shizune is the only one who actively desires to make friends note Hanako obviously has her issues with other people, as does Rin, but even the relatively popular Emi and Lilly don't let many people close for their own reasons, and sought to make people like her by doing things that she would make them happy. Unfortunately, in her alienating others through her desperate pursuit of her goal, she ends up coming off like a Tragic Hero.
Misha also implies that she was bullied for being gay, stating that originally she didn't want to go but the school sounded interesting, and that even if she was utterly hated by the other students, "at least they would leave her alone". It's awful to think that someone as cheerful as Misha would rather be hated by everyone then tormented because of her sexuality.
In the leaked beta script, Misha confirmed that she had been bullied. On top of this, she recalled an old conversation where Shizune told her that she didn't like Yamaku because it was where parents sent away children they were ashamed of, suggesting that not only did Misha think her parents let her go for this reason ("I'm one of those children nobody wants."), but that Shizune thought the same of Jigoro. While it's unclear just how much of this was preserved in the finalized backstories, it's heartwrenching to know that these were once very plausible concerns for the characters.
Misha's depression and eventual death in the leaked beta of the game.
Misha is gay, but she is so lonely and depressed that she ends up having sex with Hisao, which she obviously does not even enjoy. She explains her feelings towards Shizune to Hisao after having slept with him, a moment where the full extent of her suffering is revealed in one go. Misha is also by far the character who practices the most extensive and most genuine self-sacrifice: Lilly has been raised like this (catholic school and all that), but Misha has entirely constructed this from scratch after Shizune rejected her advances, presenting a perpetually cheerful demeanour. She is practically a christic figure, and her often being left out of the main cast is a great injustice.
Saki exists only in the 2011 April's Fool Joke by the developers, yet she got quite some attention, also because of her characterization which basically makes her a living Tear Jerker. While Hisao has to deal with a condition that puts his life constantly on the line, he'll be fine as long as he keeps up with his medication and gets some exercise. Saki's disease leaves no such hope: she may have from a few years to a couple decades left, but death will certainly come for her, and not before the disease will have gradually reduced her to a shell, finally taking away even her ability to breathe. She doesn't allow this to take the best of her, but even the happiest story with her could not be detached from a sense of constant sadness for the Foregone Conclusion that is her future. Katawa Shoujo might deal with some depressing stuff, but a story with Saki would likely blow all of the others out of the water in terms of making the reader cry.
The fact that Ritsu is a cameo character and her disability is, of all things, Carpal Tunnel Syndrome.
Meta example. The concept of the rare work of fiction willing to take the subject of disabled individuals seriously and sympathetically was welcoming to the visually impaired community in particular. Unfortunately it's very nature as a visual-based game with animations and graphics meant that very demographic was left frustrated and saddened not being able to play for themselves.