The film lacks LGBTQ+ characters and does not engage with non-cisnormative identities. Romantic and social dynamics remain strictly within traditional 19th-century heteronormative structures.

The narrative centers on a patriarchal medical hierarchy. While Eliza is a central figure, her agency is often tied to the investigations of male protagonists.

The cast is largely homogeneous and white, reflecting the 19th-century setting. There is no intentional racial blending or color-blind casting present.

The story deconstructs institutional authority by challenging the boundaries of sanity and madness. It portrays medical institutions as sites of unstable power dynamics.

The plot revolves around neurodivergence and mental health. However, these conditions often serve as mechanisms for suspense and plot twists rather than providing character agency.