Character creation offers standard male/female options with appearance sliders and gender-specific perks like Ladykiller or Black Widow that provide combat or dialogue advantages, but no pronoun systems, body-type replacements, or identity-focused customization. Background NPCs include same-sex couples such as the gay arms dealers Flak and Shrapnel at Rivet City and the lesbian ghoul couple Carol and Greta who run a hotel in Underworld and adopt Gob; these elements exist as incidental world-building without driving any subplot or serving as statements. The core narrative follows traditional hero's-journey and faction-conflict tropes with no critiques of patriarchy, systemic oppression, or modern identity politics.