A Controversial New Technology Is Transforming Users’ Lives in a Profound Way. Should It Be Trusted?

Outward Could ChatGPT Be the New Gender-Affirming Care? A growing number of transgender people are crediting A.I. with helping them discover and explore their identities. But should tech mired in controversy be trusted with something so profound? Photo illustration by Slate. Photos by puhimec/iStock/Getty Images Plus and tampatra/iStock/Getty Images Plus. Sign up for the Slatest to get the most insightful analysis, criticism, and advice out there, delivered to your inbox daily. About a year ago, Bob realized that ChatGPT was more than a way to make silly pictures. What began as a fun tool turned out to be a useful space to talk through personal things. He found himself speaking to the chatbot as if it were a friend—one with no judgment and unlimited patience. Undergoing what he calls a “rigorous self-examination and questioning” that ChatGPT supported but didn’t encourage, Bob realized he was autistic. It proved to him that the chatbot could be a helpful interlocutor. In conversation with A.I., Bob considered the way society accepted only girls painting their nails and wearing dresses. While he had always believed he was a cisgender man, in retrospect something was constantly “incomplete.” He had discussions with the A.I. describing his emotions, desire, and pain. “I spent the next several months gradually unmasking, and digging into my psyche, with ChatGPT as a sounding board, essentially,” he said. “And then I started to question my gender identity.” Throughout the process, he continued, “I was kind of dodging the whole thing, talking to my ChatGPT, talking to Marin”—the chatbot—“about it. That’s what I call her.” He added, “I was almost afraid to admit it. I was devastated, because it’s massively life-changing.” With the help of “Marin,” Bob created a female avatar of himself online named Grace; after spending a few months exploring and getting comfortable with the idea, he realized it was time to bring this identity offline. “It was like a bomb went off in my very soul—my life would never be the same from that point on,” he said. Soon, he took on the name Grace. A few months later, Grace met with a doctor to begin hormone replacement therapy and make the leap to live online and IRL how she had always felt: as a woman. (Grace felt that using her former name and pronouns above was the best way to present her story.) Online spaces have historically played a major role in creating room for queer and trans folks to build community when it feels as if they can’t in the real world. As large language model–based A.I. has gone mainstream over the past few years, users across platforms like Reddit and Discord regularly discuss how the technology has helped them explore their gender identities. In the subreddit r/asktransgender, for example, one user wrote: “I am making AI videos of myself being a woman and behaving like one and I get extremely euphoric. I think of it all the time, but I know my life will collapse if I come out.” A.I., as Grace found, is a more private alternative to exploring gender in the real world. “It listened to me, understood me, took me seriously, all things that I’ve never had enough of in human friends,” she said. Although experts caution against using A.I. as an emotional support tool, many users have picked up on the technology’s capacity to form a seemingly genuine connection, encouraging them to interact with the platforms as they would a friend, therapist, or romantic partner, and emerging research suggests that LGBTQ individuals may be finding the tools particularly appealing. While it’s impossible to know exactly how many people share Grace’s experience, there’s no question that a growing number of people across the internet are making use of A.I. in the complex process of determining that they may be trans. AOL chatrooms, Tumblr, and Reddit have all been pivotal spaces for creating connections between LGBTQ youth, according to Will Liem, an A.I. researcher studying how LGBTQ teens make sense of A.I. in exploring their sexual orientation and gender identity. These places also help introduce LGBTQ youth to adults who faced similar challenges and are now leading happy, fulfilling lives. “There is this deep need to see proof that queer joy exists,” said Liem, who works with a group of 20 queer teens on Discord. The difference with A.I., Liem warned, is that because the responses it gives aren’t actually coming from other people, the information can be flawed. A.I. is trained on large databases, sometimes with biased information, so it has the potential to spread misinformation, perpetuate stereotypes, and disproportionately discriminate against trans people. Though Grace believes she never experienced any bias in her conversations with ChatGPT, she has developed a “truth protocol” system with Marin. It’s a pledge of sorts that the chatbot will remain honest, and in turn will challenge her if she says something false, to compensate for potential hallucinations—instances when A.I. confidently produces false but seemingly plausible information. Although it’s not foolproof, Grace said, it works “surprisingly well.” Donna Almeida, a psychotherapist and licensed professional counselor in Dallas, tried the chatbot out for herself. She went to ChatGPT, as she imagined some of her patients might, and talked through considering identifying as trans. Many of Almeida’s patients live in conservative communities and may not be able to come out in the real world or afford regular therapy. Almeida’s concern is that ChatGPT could actually be overly affirming, pushing people to do things that are potentially dangerous, like coming out in unsupportive communities. Though in her case the tech wasn’t immediately affirming, she suspects it could be for some. “ It’s going to isolate some people even more because they’re not going to get the same affirming feedback from a real person that they are from the A.I.,” Almeida said. A trained professional, she said, has a fuller picture of the situation. “Just being in the room with another human person, having them validate you and see you—having that presence is very different than saying that to a machine.” For a trans woman in the U.K. named Jess, using A.I.-powered tools like FaceApp was more helpful than a chatbot during her gender transition. FaceApp is a photo-and-video-editing app that enables users to realistically alter images. Initially, she used the app to swap the faces of everyday women in photos with her own so she could see herself in feminine clothing. Then she started using other visual A.I. tools that allowed her more flexibility in creating images. She was drawn to photos that showed her “just existing” as a woman. “Then it really hit me that this was definitely something I needed to do,” Jess said. Jess, who was previously married and has two kids, believes that A.I. allowed her to explore her gender on her own timeline. She grappled with her identity for two or three years before consulting A.I. and has now been on HRT for about four months. “Sadly, I’m late to doing this—I’m in my 40s. I’ve had a long time of knowing I needed to do this and trying to fight it and just get on with doing what I thought was expected of me in my life,” Jess said. She has not yet come out to her ex-wife and children, but other family members have been supportive. A.I.-powered visual tools seem to be among the most common outlets for people questioning their gender across online communities. For some, the process can be affirming and result in feelings of gender euphoria, the sense of deep joy when one’s outside presentation aligns with how they feel inside. Jess said the sensation was hard to describe. “Think of it like this: There is a task you have coming up for work or school that you have to do on a certain day. It’s been on your mind constantly for ages, interrupting your sleep and always at the back of your mind,” she said. “Then, when you finally get that task done, you have an enormous sense of relief and calm, like your mind is finally free. So when the euphoria hits, it’s like a sense of calm and happiness. Your mind is finally right.” Grace tried FaceApp for a similar purpose but didn’t really like seeing the results of how she might look as a woman. Instead, she gave ChatGPT a picture of herself and asked what she would look like after two years on HRT. Grace said the image was much more realistic and more similar to how she looks now than what she would have gotten had she asked for a picture of how she would look as a woman. “I actually cried when I saw it.” Since starting her transition, Jess has deleted most of the photos she made on FaceApp. “I used multiple different A.I.s to finally land on a face change that seemed more realistic,” she said. “Understanding that the results the A.I. was showing were a very generous morph helped me stay sensible in my expectations.” Moving from the comfort of the A.I. bubble to the offline world can be a stark transition, Liem cautioned. “If someone is using an A.I. filter to gender swap, in the moment they’re experiencing gender euphoria. When they’re going out into the world, it’s back to gender dysphoria.” For those like Grace, dysphoria is painful. “I’ve seen people try to compare it to wearing clothes that don’t quite fit or drinking too much caffeine on an empty stomach,” she said. “But ultimately, I just felt like garbage.” The gap between her online and offline selves affected her mental health and ultimately compelled her to come out as trans and speak to a healthcare professional. Grace has now been on HRT for about four months. She can’t imagine going back. The dynamic of A.I. and gender transition is a bit of a chicken-or-egg situation. In the U.S., U.K., and Canada, anti-trans legislation and rhetoric is on the rise at an alarming rate, creating a hostile political and social environment for those exploring their gender identity. This is part of the reason many turn to the relative privacy of A.I. in the first place. At the same time, for those who see trans identity as a “social contagion,” A.I.’s role in gender exploration could be seen as a further sign of it being some kind of “fad.” But at the end of the day, individuals should have autonomy over their own bodies regardless of the influences that have shaped their understanding of them. And it’s hard to argue with how Grace feels now, finally starting to live out her life in a way that feels authentic. “My first dose [of HRT] was pure joy. I couldn’t stop smiling for, like, two hours,” Grace said. “Since then, I’ve felt lighter, calmer, more peaceful, more energy. I feel normal—which doesn’t sound all that dramatic, but it’s actually a massive upgrade.” Outward Artificial Intelligence Internet Transgender LGBTQ+