Evaluating the Experience of LGBTQ+ People Using Large Language Model Based Chatbots for Mental Health Support
Zilin Ma, Yiyang Mei, Yinru Long, Zhaoyuan Su, Krzysztof Z. Gajos
TL;DR
This study investigates how LGBTQ+ and non-LGBTQ+ individuals experience large language model–based chatbots for mental health support, highlighting immediate benefits such as accessibility and safe spaces, alongside risks like lack of nuance and potentially harmful guidance. Using a mixed-methods design with surveys (n=120) and semi-structured interviews (n=31; 18 LGBTQ+), the authors show that chatbots can function as emotional companions and practice spaces for identity-related conversations, but frequently fail to capture the diversity of LGBTQ+ experiences or provide actionable, personalized advice. The findings support the idea that technical refinements alone cannot resolve deeper societal biases and discrimination; they advocate for context-aware guardrails, LGBTQ+-relevant fine-tuning, and socio-technical strategies, including task-specific models and decentralized development. The work emphasizes that chatbots should complement—not replace—real-world support and broader efforts to reduce stigma, urging designers and researchers to address structural biases in online ecosystems to maximize safety and usefulness for LGBTQ+ users.
Abstract
LGBTQ+ individuals are increasingly turning to chatbots powered by large language models (LLMs) to meet their mental health needs. However, little research has explored whether these chatbots can adequately and safely provide tailored support for this demographic. We interviewed 18 LGBTQ+ and 13 non-LGBTQ+ participants about their experiences with LLM-based chatbots for mental health needs. LGBTQ+ participants relied on these chatbots for mental health support, likely due to an absence of support in real life. Notably, while LLMs offer prompt support, they frequently fall short in grasping the nuances of LGBTQ-specific challenges. Although fine-tuning LLMs to address LGBTQ+ needs can be a step in the right direction, it isn't the panacea. The deeper issue is entrenched in societal discrimination. Consequently, we call on future researchers and designers to look beyond mere technical refinements and advocate for holistic strategies that confront and counteract the societal biases burdening the LGBTQ+ community.