Several of the characters in The Great Believers find a deeper familial connection with friends—their chosen family—than their biological family. These chosen family dynamics highlight the ways in which shared ideas, experiences, and desires often link people more strongly than (coincidentally) shared genetics. Throughout the novel, chosen family relationships also highlight specific elements that are missing from—or need to be repaired within—characters’ biological families.

The novel significantly opens with the life celebration Fiona, Richard, Terrence, Yale, Charlie, Teddy, Asher, and Julian are holding for Nico (in place of the funeral his parents have arranged for him). This gathering of friends reflects the desires Nico articulated before he died—to have a “party” instead of a somber funeral—whereas his parents’ funeral reflects their desire to make the socially appropriate gesture: To make their son appear respectable (and less gay). This gathering embodies the dissonance gay men often experience with family members who don’t accept their sexuality (and ultimately fortifies Fiona’s commitment to ensure that the legacies and wishes of Nico’s friends are upheld).

Throughout the novel, Makkai also highlights the complex ideological variations and disagreements between members of the gay community. Charlie and Asher often argue about the efficacy of AIDS testing, the ethical superiority of monogamy versus open relationships, and the obligation to participate in gay rights activism.