The film lacks explicit depictions of non-cisnormative identities or same-sex intimacy. The narrative remains within traditional heteronormative frameworks typical of 16th-century historical dramas.

By centering on Joanna of Castile, the film uses perceived madness to critique patriarchal structures. The protagonist's struggle serves as a vehicle for agency against restrictive male authority.

The cast is predominantly white and European, reflecting the 16th-century Spanish setting. The film does not utilize diverse casting to challenge this historical homogeneity.

The narrative offers a nuanced view of institutional power, portraying the Church and monarchy as sources of confinement. It explores moral relativism through the lens of political survival.

Mental health is explored through the protagonist's psychological state as a response to systemic oppression. This portrayal grants the character agency rather than using instability for mockery.