Nymphomaniac: Vol. II features the protagonist, Joe, engaging in same-sex relationships as part of her extensive sexual exploration. These encounters are presented within the film's broader, often bleak, examination of human desire and addiction. The narrative treats same-sex interactions with the same explicit and detached tone as heterosexual ones, focusing on the acts and their psychological impact rather than specifically affirming or denigrating LGBTQ+ identity.

The film portrays family structures, gender roles, and sexual norms in a manner that explicitly challenges traditional conventions, focusing on individual sexual freedom and non-traditional relationships.

The film explores themes of sin, guilt, and societal morality, often presenting them as restrictive forces influencing the protagonist's life. It dissects the human experience within a framework shaped by Christian-influenced norms, highlighting internal conflict and transgression without affirming the faith's virtues or offering positive counterpoints.