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Koss et al. Art Int Surg. 2025;5:116-25 Artificial
DOI: 10.20517/ais.2024.91
Intelligence Surgery

Original Article Open Access

Exploring the role of ChatGPT in decision making for
gender-affirming surgery

1
2
1
Mitchell R. Koss 1 , Matthew McLaughlin , Kayla Switalla , Israel Falade , Esther Kim 3
1
School of Medicine, University of California San Francisco, San Francisco, CA 94143, USA.
2
University of Minnesota Medical School, Minneapolis, MN 55455, USA.
3
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA
94143, USA.
Correspondence to: Dr. Esther Kim, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of
California San Francisco, 350 Parnassus Ave, San Francisco, CA 94143, USA. E-mail: Esther.Kim@ucsf.edu
How to cite this article: Koss MR, McLaughlin M, Switalla K, Falade I, Kim E. Exploring the role of ChatGPT in decision making for
gender-affirming surgery. Art Int Surg. 2025;5:116-25. https://dx.doi.org/10.20517/ais.2024.91

Received: 15 Oct 2024 First Decision: 11 Dec 2024 Revised: 26 Dec 2024 Accepted: 11 Jan 2025 Published: 20 Feb 2025

Academic Editor: Andrew Gumbs Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Aim: Large language models (LLMs) like ChatGPT have transformed access to health information. For transgender
individuals considering gender-affirming surgery (GAS), accurate and reliable information is essential for informed
decision making. This study aimed to quantitatively assess the use of ChatGPT among individuals considering GAS
and its impact on their decision-making process.

Methods: A cross-sectional survey was conducted in January 2024 on Prolific. Participants included English-
speaking U.S. users over 18 whose current gender differed from their assigned gender at birth. The survey collected
demographic information, evaluated interest in GAS, and examined interactions with ChatGPT. Descriptive
statistics were used for analysis.
Results: The study included 207 participants (average age 30.2 years), primarily identifying as non-binary
(40.6%), transgender men (29.5%), and transgender women (13%). Most expressed interest in GAS (89%).
Primary information sources for GAS were online forums (24.6%), medical websites (21.3%), and social media
(17.4%). While many had used ChatGPT (73%), few utilized it for GAS information (6.7%). Among those who did,
the majority (70%) rated its usefulness as moderate to slight, with some reporting a positive influence on their
decision making (40%). Trust in ChatGPT’s information was moderate to highly rated by 80% of participants.

Conclusions: In our cohort, ChatGPT is less commonly used for GAS information than online forums and medical

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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