Contemporary GenAI chatbots, when used as digital adjuncts, may enact communication styles that can be perceived as supportive, culturally sensitive, and LGBTQI+-inclusive in specific sexual health interactions, though they lack ethical consciousness and cannot replace professional care.
Key Findings
Results
Four widely used GenAI chatbots addressed treatment-related sexual health concerns after prostate cancer using generally inclusive language, with variation in emotional tone, specificity, and cultural sensitivity.
The four chatbots tested were ChatGPT (GPT-4o; OpenAI), Claude (3.5 Sonnet; Anthropic), Copilot (GPT-4 Turbo; Microsoft), and Gemini (2.0 Flash; Google).
Interactions were conducted in February-March 2025 using a simulated 'mock patient' role assuming a gay man's perspective.
Two standardized verbatim prompts were used: one addressing general sexual health concerns after prostate cancer treatment, and one focusing on sexual minority-specific issues including same-sex practices.
Interactional features observed included scope and framing of clinical information, encouragement of dialogue, self-care advice, and explicit discussion of same-sex sexual practices.
Results
No obvious fabricated claims were identified in chatbot responses, but contextual inaccuracies were observed.
The analysis did not assess clinical effectiveness, safety, or generalizability.
The study focused on how responses were framed rather than evaluating clinical accuracy as a primary aim.
Contextual inaccuracies were noted without being further specified as constituting dangerous misinformation in this qualitative analysis.
Results
Chatbot responses were mapped along two intersecting continua yielding four distinct interactional styles.
The two continua were: logical-to-empathetic orientation and general-to-specific framing.
The four resulting interactional styles were labeled: structured overview, rational clarity, compassionate perspective, and compassionate precision.
The authors note this 4-quadrant framework 'served as an interpretive heuristic and does not constitute an evaluation of quality or effectiveness.'
This framework was derived through qualitative analysis integrating system-generated text with reflexive experiential engagement.
Background
Men who have sex with men face additional barriers to sexual health information after prostate cancer due to heteronormative assumptions, limited disclosure, and lack of culturally tailored information in clinical practice.
Sexual health concerns following prostate cancer treatment are described as 'common yet often insufficiently addressed in clinical practice.'
Heteronormative assumptions in clinical settings were identified as a specific structural barrier for this population.
The gap between clinical provision and patient need was positioned as a rationale for patients seeking information from GenAI chatbots outside traditional care settings.
Discussion
Care-like meanings may emerge through sociomaterial interactions between users and AI systems, interpreted through actor-network theory.
The study used auto-netnography as its qualitative methodology, with the first author acting as the interacting researcher-participant.
Actor-network theory was applied as an interpretive lens alongside netnographic analysis.
The authors conclude that 'care-like meanings may emerge through sociomaterial interactions between users and artificial intelligence systems rather than demonstrating generalized performance or clinical reliability.'
Each chatbot was interacted with once, limiting claims about consistency or reproducibility of responses.
Conclusions
GenAI chatbots' performative responses may complement clinical practice by facilitating reflection and access to sensitive information, despite lacking ethical consciousness.
The authors explicitly state these systems 'lack ethical consciousness and cannot replace professional care.'
The proposed role is as 'digital adjuncts' that complement rather than substitute for professional clinical care.
The study frames chatbot utility in terms of facilitating patient reflection and access to sensitive information rather than providing clinical guidance.
The findings are described as pertaining to 'specific sexual health interactions' and not generalizable performance.
What This Means
This research suggests that AI chatbots like ChatGPT, Claude, Copilot, and Gemini can provide sexual health information to gay men who have had prostate cancer in ways that feel supportive and culturally sensitive. The study had a researcher act as a simulated gay male patient and ask the same questions about post-prostate cancer sexual health across all four platforms. The chatbots varied in how warm versus clinical their tone was, and how general versus specific their information was, leading the researchers to categorize four different 'styles' of response. Importantly, no obvious false medical claims were detected, though some contextual inaccuracies appeared.
This matters because gay and bisexual men with prostate cancer often encounter healthcare settings that assume all patients are heterosexual, leaving them without tailored information about issues like same-sex sexual practices, anal intercourse after treatment, or disclosure to same-sex partners. The study found that AI chatbots may partially fill this gap by providing a private, non-judgmental space to ask sensitive questions that patients might feel reluctant to raise with a clinician.
This research suggests AI chatbots could serve as a supplement — not a replacement — for professional medical care in this context. The study was small and exploratory (one interaction per chatbot, one researcher-patient), so the findings reflect a snapshot rather than a systematic evaluation. The authors emphasize that these systems do not have genuine understanding or ethical judgment, and that the 'care-like' quality of their responses is a feature of how they are designed to communicate, not evidence of clinical reliability.
Christiansen M, Eriksson H, Fagerström L. (2026). Generative AI Chatbots as Digital Adjuncts for Sexual Health Information After Prostate Cancer in Men Who Have Sex With Men: Auto-Netnographic Study.. JMIR cancer. https://doi.org/10.2196/81745