American Me portrays same-sex sexual acts almost exclusively as acts of violence, power, and degradation within the brutal prison environment. The protagonist experiences and perpetrates sexual assault, framing these encounters as sources of trauma and misery rather than expressions of genuine LGBTQ+ identity or relationships.

The film features J.D., a transsexual woman, whose portrayal is overwhelmingly negative. Her identity is a source of extreme vulnerability, leading to repeated sexual assault and murder within the prison. The narrative presents these punitive outcomes without counterbalance or critique, failing to affirm the character's dignity or worth.

The film portrays Christianity, specifically Catholicism, as a significant cultural and moral anchor, particularly through Santana's devout mother whose faith is depicted with respect and as a source of strength. While some characters may fail to live up to its tenets, the narrative itself affirms the virtues and dignity of the faith, highlighting the human struggle for redemption.