In an article in the Journal of Medical Ethics — one of the field’s most influential publications — an independent researcher argues that transgender people should be granted access to AI-generated “digital twins” to allow them to “design” themselves before undergoing transition interventions. From “Designing Inclusive Digital Twins: Ethical and Practical Considerations for Trans Healthcare”:

DTs combine AI, big data analytics and sensor technology to create dynamic, patient-specific models that enhance diagnosis, prognosis and treatment planning. For trans individuals, DTs could transform gender-affirming care by offering precise simulations of HRT effects, such as changes in body composition or emotional well-being, or visualising surgical outcomes tailored to individual goals.

This means a lot of reprogramming of AI software:

Current datasets often lack trans-specific data, leading to biased or incomplete models that fail to reflect the physiological and identity diversity of trans populations. Static DTs risk misrepresenting the evolving nature of gender identities, potentially alienating users whose identities shift over time. Privacy is a critical concern, as trans individuals face heightened risks of discrimination if sensitive data are mishandled, necessitating robust encryption and patient-controlled access protocols. Socioeconomic barriers also threaten equitable access, as high costs could exclude marginalised trans individuals, exacerbating existing healthcare disparities. Overcoming these challenges requires inclusive design strategies rooted in collaboration with trans communities and a commitment to equity.

In other words, it would be a never-ending process to reflect the “fluidity” of “queer” experience. And, it would surely have to be covered by health insurance and/or government benefits to ensure that “digital twins” are available to all gender-fluid people, not just the wealthy, as a matter of “equity.”

I bring this radical advocacy to your attention, dear readers, because it illustrates how medicine is no longer just about treating disease, healing injuries, and promoting physical wellness. Indeed, the armamentarium of the doctor is increasingly being co-opted to satisfy subjective personal lifestyle desires and fulfill deeply emotional obsessions, in this example, what the author calls “fostering an equitable healthcare system” to “foster trans liberation.” (Have the wants and desires of any subset of the population ever received as much solicitation as those of transgender individuals?)

This article’s logic also promotes using AI and other tools to fulfill the desires of transhumanists. Because if society should pay for transgender people’s digital twins, why not pay for similar things for everyone who has a deep yearning to engage in personal recreationism (a term coined by Leon Kass), such as mentally ill people obsessed with becoming disabled (body integrity identity disorder), growing a prehensile tail, or enhancing their physique through gene-editing or surgical implants?