# Perspectives on Cross-Lingual Consistency in LLMs for Medical Questions

arXiv: https://arxiv.org/abs/2609.07687 · HTML: https://mlsanity.com/paper/2609.07687/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 20 of its 43 references that are in the map.
- First posted on arXiv 7 Sep 2026.

## Builds on (most cited first, 20 of 20)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [XNLI: Evaluating Cross-lingual Sentence Representations](https://mlsanity.com/paper/1809.05053/) (2018)
- [XTREME: A Massively Multilingual Multi-task Benchmark for Evaluating Cross-lingual Generalization](https://mlsanity.com/paper/2003.11080/) (2020)
- [HealthBench: Evaluating Large Language Models Towards Improved Human Health](https://mlsanity.com/paper/2505.08775/) (2025)
- [Challenges and Strategies in Cross-Cultural NLP](https://mlsanity.com/paper/2203.10020/) (2022)
- [Towards Measuring and Modeling "Culture" in LLMs: A Survey](https://mlsanity.com/paper/2403.15412/) (2024)
- [Probing Pre-Trained Language Models for Cross-Cultural Differences in Values](https://mlsanity.com/paper/2203.13722/) (2022)
- [CMB: A Comprehensive Medical Benchmark in Chinese](https://mlsanity.com/paper/2308.08833/) (2023)
- [Towards Building Multilingual Language Model for Medicine](https://mlsanity.com/paper/2402.13963/) (2024)
- [Better to Ask in English: Cross-Lingual Evaluation of Large Language Models for Healthcare Queries](https://mlsanity.com/paper/2310.13132/) (2023)
- [Apollo: A Lightweight Multilingual Medical LLM towards Democratizing Medical AI to 6B People](https://mlsanity.com/paper/2403.03640/) (2024)
- [SUTRA: Scalable Multilingual Language Model Architecture](https://mlsanity.com/paper/2405.06694/) (2024)
- [WorldMedQA-V: a multilingual, multimodal medical examination dataset for multimodal language models evaluation](https://mlsanity.com/paper/2410.12722/) (2024)
- [Multi-OphthaLingua: A Multilingual Benchmark for Assessing and Debiasing LLM Ophthalmological QA in LMICs](https://mlsanity.com/paper/2412.14304/) (2024)
- [Do LLMs Provide Consistent Answers to Health-Related Questions across Languages?](https://mlsanity.com/paper/2501.14719/) (2025)
- [Explanatory Argument Extraction of Correct Answers in Resident Medical Exams](https://mlsanity.com/paper/2312.00567/) (2023)
- [Exploring the Comprehension of ChatGPT in Traditional Chinese Medicine Knowledge](https://mlsanity.com/paper/2403.09164/) (2024)
- [Discrepancy Detection at the Data Level: Toward Consistent Multilingual Question Answering](https://mlsanity.com/paper/2510.11928/) (2025)
- [Beyond the Rubric: Cultural Misalignment in LLM Benchmarks for Sexual and Reproductive Health](https://mlsanity.com/paper/2511.17554/) (2025)
- [Multilingual Medical Reasoning for Question Answering with Large Language Models](https://mlsanity.com/paper/2512.05658/) (2025)

## Abstract (arXiv)

Should multilingual LLMs answer medical questions consistently across input languages, or adapt responses to cultural cues? Existing multilingual medical benchmarks usually assume that medically correct answers should remain consistent across languages and treat cross-lingual variation as model error. In contrast, cultural adaptation research argues that appropriate medical answers may legitimately differ across contexts. We review the multilingual medical NLP literature through these two perspectives, we identify three gaps: limited stakeholder perspectives (e.g., of medical professionals), a lack of empirical evidence on which approach better serves users, and no benchmarks capable of distinguishing universally correct from culture-specific cases. To address the first gap, we survey 356 participants across three stakeholder groups (medical, NLP, and anthropology professionals) in three countries (Germany, Spain, and the United States). Anthropologists consistently favor adaptation, while medical and NLP respondents remain divided, with notable divergence between U.S. and European medical professionals. LLMs prompted with profession and country personas fail to reproduce this variation, overestimating cross-lingual consistency preference among NLP and medical personas. We conclude that neither consistency nor adaptation can currently be considered clearly preferable, highlighting the need for empirical evidence on which approach better serves users across cultural contexts.