Absolutely brilliant minimalist design. Do not change a thing. My only suggestion might be that you print "Yeah, it's that fucked up" UPSIDEDOWN underneath the UPSIDEDOWN head. This will be suggestive that the throatfuckee is at least as complicit in the horror that is Gag Factor as the throatfuckers and throatfuck producers. You see, then these dumb whores aren't just victims of a few degenerate pornographers but of an entire culture that has confused them to such a point that they are unable to read the writing on the wall (even though it is UPSIDEDOWN like them).
One other idea is that you might place a pink bow atop (underneath) the UPSIDEDOWN head, but that might be going to far and ruin the purity of the design.