Love Lies Bleeding centers on the passionate and tumultuous relationship between Lou and Jackie, a lesbian couple navigating a violent criminal underworld. The film portrays their bond with complexity and agency, making their love a driving force amidst external dangers and family dysfunction. The narrative affirms the worth of their queer identity and relationship, even as they face brutal challenges.

Love Lies Bleeding features Jackie, a transsexual bodybuilder, as a central character. The film portrays her with significant agency, ambition, and complexity as she navigates a violent criminal underworld. Her trans identity is an integral part of her character, depicted with dignity and respect, rather than being a source of mockery or degradation. The narrative focuses on her intense relationship and pursuit of personal goals amidst challenging circumstances.

The narrative celebrates alternative family structures and sexual freedom, while critically depicting a highly dysfunctional patriarchal family unit and undermining traditional parental authority.

The film depicts a central antagonist who is a violent, hypocritical crime boss, frequently employing Christian rhetoric and symbols while engaging in brutal and oppressive acts. This portrayal links a specific manifestation of Christianity to control, violence, and moral corruption, without presenting any counterbalancing positive depictions. The narrative uses this character's 'faith' to underscore his depravity and the toxic environment he creates.