Casting features a notably diverse ensemble for a 2017 medical drama, including prominent black surgeons (Dr. Claire Browne and Dr. Jared Kalu) and Asian executives, which feels organic to a modern U.S. hospital but aligns with identity-focused representation.

Episode 14, 'She,' prominently features a transgender teenage patient (biologically male identifying as female) with testicular cancer, where Shaun advocates for respecting her gender identity over parental objections, serving as a clear 'lecture' moment on LGBTQ+ inclusion and patient autonomy that has drawn both praise for affirmation and criticism as cringeworthy messaging. Other episodes touch on international diversity (Congolese patient) and subtle subplots of racism/sexism alongside the disability theme, but these do not dominate the procedural medical cases.

No evidence of forced race/gender-swaps from the Korean source material or creator-stated activist intent; David Shore focused on character-driven drama. Audience reception was overwhelmingly positive as a hit show with minimal contemporaneous woke backlash, though later rewatches highlight the trans episode and autism tropes as grating, without 'go woke go broke' impact on Season 1's success.