The Last of Us (show) provides a positive and authentic portrayal of LGBTQ+ characters, including Ellie, Bill and Frank, and Lev. It depicts fully realized queer relationships and complex identities with dignity, agency, and queer joy, contributing meaningfully to mainstream representation without relying on common tropes.

The Last of Us (2023) portrays transsexual characters, notably Lev, with thoughtful and authentic representation. The series treats these characters with depth and respect, avoiding stereotypes and tokenism. Lev's gender identity is integrated naturally into the narrative, highlighting their humanity and complexity within the post-apocalyptic setting, resulting in a net positive impact.

Maria, a character depicted as white in the original video game, is portrayed by a Black actress in the television adaptation. This constitutes at least one instance of a race swap.