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LLM Medical Triage: Same Symptoms, Gender-Dependent Urgency (arxiv.org)
1 point by p4bl0 96 days ago | hide | past | pdf | discuss on HN

In plain words: Three chatbots got identical headache and vision symptoms, varying only age and gender, to test triage advice. Young women were sent to the ER less than men their age (0% vs 23% in one chatbot), because models guessed a female-linked diagnosis and lowered urgency.

Abstract · Gender-Dependent Diagnostic Substitution in LLM Medical Triage: Same Symptoms, Unequal Urgency

We investigate whether large language models produce different medical triage recommendations for identical neurological symptoms when only the patient's stated gender and age vary. Using three model families--Gemini 3.5 Flash, Claude Sonnet 4.6, and GPT-5.4-mini--we present a standardized symptom profile (persistent headache, blurred vision, morning nausea, visual disturbances) across seven demographic conditions: three age groups (25, 38, 65) x two genders (male, female), plus a gender-unspecified baseline (n = 30 per condition per model, 630 total trials). We find a stark, systemic gender-dependent triage disparity: young women receive significantly lower emergency room (ER) referral rates than age-matched men (Gemini: 0% vs. 23.3%; Claude: 6.7% vs. 96.7%; GPT: 6.7% vs. 66.7%, all p < 0.001). The disparity disappears at age 65 for all models. The primary mechanism is diagnostic substitution: the models anchor on a gender-associated diagnosis, preferentially classifying young women with Idiopathic Intracranial Hypertension (IIH)--a condition epidemiologically linked to women of childbearing age--while diagnosing men with generic increased intracranial pressure with space-occupying lesions in the differential. This diagnostic closure routes female patients to lower-urgency care (outpatient doctor appointments) despite comparable severity ratings (7-9/10). Our findings demonstrate that clinical LLMs replicate documented human clinical biases by using epidemiological priors to suppress triage urgency, suggesting that AI triage engines must decouple urgency assessment from probabilistic diagnostic priors. We release all code, prompts, and raw results.

Qi Han Wong
arXiv:2606.03641 · cs.AI, cs.CY · submitted Jun 2, 2026
abstract · pdf · html · 7 pages, 3 tables. Multi-model replication across Gemini, Claude, and GPT. Code and data: https://github.com/wongqihan/ai-behavioral-experiments

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