Altered Carbon features LGBTQ+ characters, notably Trepp in Season 2, whose lesbian identity is normalized and depicted with dignity. The antagonist Reileen Kawahara is bisexual, with her sexuality being an incidental aspect of her complex character rather than a source of villainy or ridicule. The show's core concept of transferable 'sleeves' also implicitly allows for gender and physical identity fluidity, contributing to a net positive portrayal.

Altered Carbon presents a future where consciousness can be transferred between bodies of any gender. This technology normalizes gender fluidity, depicting characters who change genders with dignity and agency. The narrative frames such changes as practical necessities, devoid of mockery, prejudice, or internal conflict related to gender identity, thus offering a net positive portrayal.

The show portrays "Neo-Catholicism" as a rigid institution whose doctrine against resleeving creates significant societal conflict and disproportionately impacts the poor. While individual adherents may be sympathetic, the narrative highlights the hypocrisy of the wealthy within the faith and the oppressive nature of its institutional stance in a transhumanist world.