That was illustrative of some of the biases that take place. I know that happens with other minority groups. Once I actually do tell people that I’m gay, then there is the immediate worry or fear that people will think of me in a different light. Will they see me as a certain stereotype? Will they think of me in a sexualized manner? Once you tell someone you’re gay, you’re telling them what you like sexually. That is something that I think in a heterosexual or heteronormative environment does not happen.

Every time I have a conversation with someone about my family, I’m having a “coming out” type of moment if someone didn’t see me in that light. That can be difficult because I have to guess if that person is going to be supportive. Are they going to turn away? Are they going to think of me in a negative fashion?

KK: Steve, did you see the picture of Adam’s alternative family?

SF: I did see it, and I had some real questions for Adam when I got home.

It did prompt a lot of conversation. Lots of other people saw that nationally, and they know Adam. People did question if something had changed.

KK: Steve, what about your experiences?

SF: Well, I think in residency and fellowship as a cardiologist, it’s much more conservative than emergency medicine. I had a real concern because I didn’t know any other people nationally who were gay and a cardiologist.

Adam Brown and Steve Farmer

I was very careful about not revealing my sexuality while in training because I didn’t want it to prevent my getting a fellowship at Penn and I didn’t want it to impact my job search. When I did apply for jobs, I was very explicit that I was gay because I didn’t ever want to be in a situation where I joined a group that was in any way uncomfortable with it.

It frequently happens that patients will speak with me and make assumptions about my being married because they see my ring or for other reasons. In DC, I have a lot of African American patients, and maybe I’m coming back at them with my own biases, but my sense is that gay men are less acceptable in the African American culture than they are in some other groups. I usually deflect the question or ignore it. It’s kind of awkward, clinically speaking, because I never really say who I am, which I think is an impediment to being authentic with patients.