@inproceedings{ahsan-etal-2025-elucidating,
title = "Elucidating Mechanisms of Demographic Bias in {LLM}s for Healthcare",
author = "Ahsan, Hiba and
Sen Sharma, Arnab and
Amir, Silvio and
Bau, David and
Wallace, Byron C",
editor = "Christodoulopoulos, Christos and
Chakraborty, Tanmoy and
Rose, Carolyn and
Peng, Violet",
booktitle = "Findings of the Association for Computational Linguistics: EMNLP 2025",
month = nov,
year = "2025",
address = "Suzhou, China",
publisher = "Association for Computational Linguistics",
url = "https://aclanthology.org/2025.findings-emnlp.789/",
pages = "14614--14631",
ISBN = "979-8-89176-335-7",
abstract = "We know from prior work that LLMs encode social biases, and that this manifests in clinical tasks. In this work we adopt tools from mechanistic interpretability to unveil sociodemographic representations and biases within LLMs in the context of healthcare. Specifically, we ask: Can we identify activations within LLMs that encode sociodemographic information (e.g., gender, race)? We find that, in three open weight LLMs, gender information is highly localized in MLP layers and can be reliably manipulated at inference time via patching. Such interventions can surgically alter generated clinical vignettes for specific conditions, and also influence downstream clinical predictions which correlate with gender, e.g., patient risk of depression. We find that representation of patient race is somewhat more distributed, but can also be intervened upon, to a degree. To our knowledge, this is the first application of mechanistic interpretability methods to LLMs for healthcare."
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<abstract>We know from prior work that LLMs encode social biases, and that this manifests in clinical tasks. In this work we adopt tools from mechanistic interpretability to unveil sociodemographic representations and biases within LLMs in the context of healthcare. Specifically, we ask: Can we identify activations within LLMs that encode sociodemographic information (e.g., gender, race)? We find that, in three open weight LLMs, gender information is highly localized in MLP layers and can be reliably manipulated at inference time via patching. Such interventions can surgically alter generated clinical vignettes for specific conditions, and also influence downstream clinical predictions which correlate with gender, e.g., patient risk of depression. We find that representation of patient race is somewhat more distributed, but can also be intervened upon, to a degree. To our knowledge, this is the first application of mechanistic interpretability methods to LLMs for healthcare.</abstract>
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%0 Conference Proceedings
%T Elucidating Mechanisms of Demographic Bias in LLMs for Healthcare
%A Ahsan, Hiba
%A Sen Sharma, Arnab
%A Amir, Silvio
%A Bau, David
%A Wallace, Byron C.
%Y Christodoulopoulos, Christos
%Y Chakraborty, Tanmoy
%Y Rose, Carolyn
%Y Peng, Violet
%S Findings of the Association for Computational Linguistics: EMNLP 2025
%D 2025
%8 November
%I Association for Computational Linguistics
%C Suzhou, China
%@ 979-8-89176-335-7
%F ahsan-etal-2025-elucidating
%X We know from prior work that LLMs encode social biases, and that this manifests in clinical tasks. In this work we adopt tools from mechanistic interpretability to unveil sociodemographic representations and biases within LLMs in the context of healthcare. Specifically, we ask: Can we identify activations within LLMs that encode sociodemographic information (e.g., gender, race)? We find that, in three open weight LLMs, gender information is highly localized in MLP layers and can be reliably manipulated at inference time via patching. Such interventions can surgically alter generated clinical vignettes for specific conditions, and also influence downstream clinical predictions which correlate with gender, e.g., patient risk of depression. We find that representation of patient race is somewhat more distributed, but can also be intervened upon, to a degree. To our knowledge, this is the first application of mechanistic interpretability methods to LLMs for healthcare.
%U https://aclanthology.org/2025.findings-emnlp.789/
%P 14614-14631
Markdown (Informal)
[Elucidating Mechanisms of Demographic Bias in LLMs for Healthcare](https://aclanthology.org/2025.findings-emnlp.789/) (Ahsan et al., Findings 2025)
ACL