The game features multiple LGBTQ characters and quests, including a prominent gay skeleton pirate romance subplot and established lesbian elements tied to Tiny Tina. Most significantly, Paladin Mike is a transmasc NPC presented with he/him pronouns, trans flag-colored armor, and explicit ties to prior trans representation via the same voice actor. Character creation includes pronoun selection options and gender-neutral language presets, normalizing identity customization in a fantasy setting.

These elements appear in main and side content without being the sole focus, but they extend the Borderlands series' pattern of foregrounding such representation. Audience reactions include direct backlash labeling the pronoun prompts and trans character as 'woke' or intrusive, with some players uninstalling immediately. Critic scores (78 on Metacritic) outpace user scores (5.8 mixed), reflecting a gap amid complaints about writing and characters. While the core premise remains a chaotic loot-shooter fantasy adventure, the identity-focused casting and mechanics introduce contemporary social framing that disrupts traditional escapism and prioritizes representation over organic world-building.