Tropical Malady centrally features a tender gay romance between Keng and Tong in its first half, depicting their intimacy and affection with dignity and complexity. The film avoids external prejudice, presenting their love as natural and valid. Even as the narrative shifts to a more abstract, spiritual exploration in the second half, the initial portrayal affirms the worth of their queer relationship, resulting in a profoundly positive net impact.

The film primarily focuses on a same-sex romantic relationship, which, while not explicitly critiquing traditional family structures, normalizes a non-traditional partnership arrangement. Other aspects of family life, such as parenting, gender roles in the home, or multigenerational family bonds, are largely absent from the narrative.

While not overtly religious in a doctrinal sense, the film's setting in Thailand and its exploration of themes like reincarnation, the interconnectedness of beings, and a respectful engagement with the natural world imbue the narrative with a subtle, culturally Buddhist sensibility. These spiritual undertones are treated with reverence.