Artificial intelligence and immersive technologies for LGBTQ+ youth: a narrative review

Introduction Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) youth face elevated rates of mental health difficulty alongside persistent barriers to affirming professional care. AI-powered chatbots and virtual reality (VR) and metaverse environments have both been proposed as ways of reaching this population, but the two literatures have developed separately, and we identified no review covering both for LGBTQ+ youth specifically. Objective To map current applications of AI chatbots and VR/metaverse tools for LGBTQ+ youth, examine risks related to algorithmic bias and online safety, consider how digital environments may support identity affirmation, and identify priorities for research and practice. Methods We conducted a narrative review; a format suited to evidence that is sparse and varied in design. Searches ran across PubMed, Scopus, and Google Scholar using seven search string combinations, supplemented by reference list screening and citation tracking. Of 367 records from the original search and 180 from a supplementary search, 67 sources informed the synthesis; 12 provided direct evidence from LGBTQ+ young people. Empirical studies were appraised with the Mixed Methods Appraisal Tool. Results Four themes emerged. AI chatbots are acceptable to LGBTQ+ young people and valued for their anonymity, but current tools give generic responses and perform poorly outside North American and Western European contexts. VR and metaverse environments support avatar-based identity exploration and embodied community connection, with early evidence of feasibility for transgender and gender expansive youth. Algorithmic bias is a documented harm, operating through content moderation, facial recognition, and language model outputs. In co-design studies, LGBTQ+ young people identified gaps that developers had missed, although no study has yet compared co-designed tools with conventionally developed ones. Conclusion These technologies have real potential, but the evidence base does not yet support strong claims. Most studies are pilot or feasibility designs with small samples, concentrated in a handful of high-income countries. Progress requires more rigorous trials, greater geographic diversity, wider use of participatory design, tested against conventional development, and outcome measures that capture affirmation as well as symptom reduction, for which validated instruments do not yet exist.