The film depicts adult Stan in a relationship with a trans woman and adult Kyle with a man. These relationships are presented as unexpected, comedic elements within the characters' bleak future, contributing to the narrative's shock value rather than offering a strong positive or negative stance on LGBTQ+ identity.

The film features a transsexual character, Nicole, as the wife of Wendy Testaburger. Her identity is present but incidental to the main plot, neither serving as a source of affirmation nor denigration. The portrayal is neutral, acknowledging her identity without making it a central theme or subject of commentary.

The film uses Cartman's conversion to Judaism as a central plot device, but the satire is directed at Cartman's character and his self-serving nature, not the faith itself. His Jewish family is depicted as loving and wholesome, and the narrative ultimately frames Cartman's profound sacrifice within the context of his commitment to this family, lending a positive association to the family unit and the values it embodies.