Suburra: Blood on Rome features Spadino, a central gay character whose identity is explored with depth and empathy. The series portrays his secret relationship with tenderness and frames the numerous obstacles he faces as external pressures from his conservative criminal environment, rather than issues with his identity itself. This approach validates his experiences despite the tragic elements.

The series consistently portrays the Catholic Church, particularly its higher echelons and the Vatican, as deeply corrupt, entangled with organized crime, and driven by power and greed rather than spiritual values. The narrative exposes widespread hypocrisy and moral failings within the institution, with little counterbalancing positive portrayal of the institution itself.