The film features a sadistic lesbian guard and depicts same-sex relationships among prisoners, often for survival or exploitation. These portrayals reinforce harmful stereotypes and sensationalize queer identity within a degrading prison environment, resulting in a net negative impact.

The Big Doll House features Bodine, a transsexual woman, whose identity is primarily used for sensationalism within the exploitation genre. Her portrayal leans into harmful stereotypes, depicting her as an 'othered' figure in the women's prison. The film does not offer an affirming or empathetic view of her trans identity, instead using it to contribute to the film's gritty and often problematic atmosphere without critique.

The film features female prisoners, particularly Collier and Grear, who engage in direct physical combat against male prison guards during an escape attempt. These characters are shown to be victorious in close-quarters fights, using their strength and fighting skills to overcome their male opponents.