Hawthorne features Bobbie Jackson, a main character who is openly lesbian. Her relationships are portrayed with dignity and normalcy, integrating her sexuality as a natural aspect of her identity. The narrative treats her same-sex relationship with the same respect and emotional depth as heterosexual relationships, focusing on her professional and personal challenges rather than her sexual orientation being a source of conflict or negative stereotypes. The overall portrayal is affirming.

Hawthorne portrays a pregnant transgender man, Danny, with dignity and empathy. The narrative focuses on his medical journey and the challenges he faces, framing initial misunderstandings as external obstacles. The show ultimately affirms his identity and the worth of his family.

The series, typical of medical dramas, portrays Christianity as a source of comfort, strength, and moral guidance for many characters. While individual beliefs might present medical challenges, the narrative generally respects adherents' faith and portrays them with empathy and nuance, aligning with the dignity of their beliefs.