Pain and Glory offers a deeply personal and empathetic portrayal of a gay film director, Salvador Mallo. His queer identity is central to his character, relationships, and artistic journey, depicted with dignity and complexity, affirming the worth of LGBTQ+ lives and love.

The film features a significant character, Federico, who is revealed to have transitioned to a woman, a development handled with dignity and empathy. A minor character, Pura, is also mentioned respectfully. The portrayals affirm transsexual lives without sensationalism or judgment, contributing positively to the film's themes of memory and evolving identity.

The film portrays Catholicism as a significant and formative part of the protagonist's childhood and his mother's life. Nuns are depicted with respect, recognizing young Salvador's artistic talent, and his mother's devout faith is shown with dignity, contributing to a nuanced and sympathetic portrayal.