Ep 67: AI and delusions of beauty, with Gretchen Andrew

The Medical AI Podcast Welcome to the Medical AI Podcast, with me, Dr Felix Beecher. Strap in for a 30 minute thrill ride of big ideas. And for world-class coaching and consultancy in health tech, check out callcoaching.co.uk Normally, on this amazing podcast, I cover AI systems that can potentially help with medical treatment. Today, however, we are discussing an angle on the harms of AI on health. In particular, we look at whether AI tools are providing a particularly pernicious and powerful way in which our perceptions of beauty are coming distorted. Are these distorted perceptions setting us up for anxiety, depression and even body dysmorphia? And with me, I'm delighted to say to discuss this, is the joy in of the art world and AI provocateurs, the amazing and wonderful Gretchen Andrew, Gretchen, a huge welcome to the podcast. Great, thank you so much for having me. As you said in your introduction, I'm a visual artist who explores AI's impact on our self-perception on beauty standards. And particularly today, we're going to discuss how this impacts mental health and also trends in plastic surgery. Yes, I mean, I'm really thrilled to be covering this. It's completely different from the kind of thing I've done before. And I think it's a very interesting angle. But before we dive in Gretchen, why don't you introduce yourself to people who may not have heard of you before? So I operate primarily in the fine art world as an artist who investigates ways in which artificial intelligence is making life more boring or more controlled. So much of this podcast focuses on really cool advancements that are going to help us. And I think it's important that I use my artwork and podcasts like this to also talk about the ways in which AI is maybe more perniciously impacting us and potentially what we can do about that. And I think it's not just you, of course. I think it's become increasingly fashionable for great luminaries in the AI world like Jeffrey Hinton and Elon Mask to talk more about the severe harms of AI or risks of AI. So I think you're in good company, right? Well, it really depends upon what we define as good company. But it is an important area of cultural criticism and understanding. And I think one of the various things that we can do is demystify it a little bit. Because when we think of it as this over our gene technology that we have no control over, then it is a lot more scary and negative than when we take it down to the level of face tuning and people getting huge lips put on their faces. We can sort of make it more approachable, I think. So Gretchen, I think you're probably somewhat unusual as an artist because you also have a background in AI. Could you just talk a little bit about that? So I originally started my career in tech. And what I found is I was seeing technology, what was this 15 years ago, primarily used to manipulate our attention and sell us things we don't need. I very firmly believe that the impact of social media on mental health will be the tobacco of our generation. And so I started thinking about how I can use art and the art world to broaden conversations where things that are normally complicated or invisible can see more approachable. And started a whole journey of going into the art world to do that. But my training is in tech. And I very much love the potential of technology as a tool for good, as a tool for personal transformation. And it's something that I think has come up on this podcast as well that with AI having such medical implications, how much of the AI processing resources are actually being put towards that kind of good compared to whatever else we're doing with it. And so it's a passion that has pervaded my journey as an artist even though I did start in tech. So could you briefly explain to people what your art is and what it looks like and what it means if that's not a silly question? No, that's great. And always love having to do this on without any visuals. Oh my gosh, I got into being an artist so that I could, you know, show things. But no, the so it's very common these days to use filters on social media, but also on zoom on LinkedIn filters or AI-driven algorithms called face tune generically that change how we look to make us look more presentable. Sometimes it's a very subtle change that maybe makes our skin look smoother. Sometimes it makes us look younger. Sometimes people are full on changing their faces and their bodies and then posting themselves on dating apps. And what I do in my paintings is I take those same algorithms, those same filters and make the process physical so that instead of invisibly moving pixels around to change your faces and our bodies, it is messily dragging wet paint so that every time the AI-driven beauty standards disagree with how we look compared to the ideal, it becomes a mark and a scar and these become portraits of really the difference between how we look and how AI says we should look. This is fascinating because I would imagine that most people listening to a discussion about face tuning or body tuning, whatever it might be, might think that it's just a bit of harmless fun or maybe it's a bit of harmless fun for most people, maybe some people take it too seriously or something, but overall maybe it's probably not the kind of thing that people give much thought to, is that fair? Absolutely and that's one of my big passions in this is that we really should. There are so many implications around body dysmorphia, mental health. If you think about how much time, especially young people today, spend online versus with other peers, with people in the real world, their expectations of how people look and are supposed to look are being trained through faces and bodies that literally do not exist. Beauty standards have always been a part of cultures, but never before have we looked at so many faces and bodies that are changed by AI are changed by these filters and therefore expectations of what it means to be beautiful, what it means to look a certain age, have drastically shifted. So can you do you have without naming names or anything? Do you have any case studies or experiences from your personal experience of this kind of thing happening and the harms that it might cause? Yeah well the New Yorker did an article on teen suicide maybe six or seven months ago and in that one of the case studies within that article really pulls out the story of this girl who was looking at social media, she was looking at Snapchat, she was looking at Instagram, she was looking at TikTok and literally saying in her diary and to her parents and to her friends I could never be that pretty. And what's crazy about this is no one literally no one is that pretty. These bodies these people are changing their faces that when we look in the mirror it's a completely different experience and a mental health foundation report in the UK share that 40% of young people said images on social media have caused them to worry about their own bodies. I know I respect you know recently there was a quite a fuss about the emergence of a virtual actress whose name I can't remember but there were lots of Hollywood actresses very upset about this and I can imagine that they might well be because they might feel that they're not as pretty and perfect as these AI generated yet very very critical renditions of people. Is that part of the same thing in your mind? Oh absolutely. We're human and humans get diseases, humans age, humans are inconvenient and have opinions and preferences and an AI person will have none of this and that lack of mess is why especially actress and actresses who whose bodies and whose work were probably used to train this AI actress. In every role we worry about oh is AI going to replace me and in so many cases Hollywood being a great example of this the these people who are being replaced or could be replaced helped train their replacement as someone who won't age who won't get sick who won't have a fight with the producer and a lot of that messy of what it means to be human, there's a feeling that we can just program it out of our culture. Yeah, I think also with Optimus being released next year, it's very easy to imagine that we could be in this Isaac Asimov kind of world pretty soon where robots are not just being used to wash the dishes, but also being used like that film with Meghan Foxx, sex robots, where people can have physical, physically perfect looking robots that don't menstruate or get sick or don't complain or whatever you mean. So do you think that's something that you see happening in our lifetime? Or what? Yeah, I mean, when we go into the world of robotics and it becomes physical, I think there are a couple of technology hurdles, but there's a lot of research already about people being in relationships with AI. The movie "Her" is absolutely upon us as far as the disembodied relationship that we have. I also see this a lot with men where there's a semi-lacrum of male friendship through things like the manosphere podcasting and YouTubers and a lot of the expectations of what it means to be male and masculine today. Maybe it's the jawline or this desirable masculine abs or height or not holding. People are seeing these men who a lot of them have had jaw surgery. And they're seeing them on flat screens where how we look in two dimensions is not how we look in three dimensions. And there's such a set of expectations of not just I need to do certain things to be a man. I have to look a certain way to be a man. And I'm seeing a huge increase in that. And I think how that relates to your question about where we are with the sex robot, robots and the other forms of intimacy being replaced is twofold. These apps and AI is not just changing our expectations of what we are supposed to look like. It's changing your expectations of what other people are supposed to look like. And having real sex is not a robot experience. It is wonderfully messy a lot of the time. And that expectation that it be very sanitized, that it be very one-sided, whatever the robots are going to be programmed to please us as is absolutely a concern because I think that pervades not just the use of AI as a therapist or as a friend or as a romantic partner, but how people are supposed to be more asyqueous or more agreeable. It's fascinating. We could talk about this all day long. Because I think once this is something I've reflected on before, but I think once viable robots arrive that you can have sex with and have a conversation with and can help around the house, then that genuinely looks like the apocalypse to me. Because the thing is I think for every Gretchen Andrew who thinks that's a horrible thing. There are probably three or four people who think that that's shangri-lar. That's when that's as good as life could get. I don't know. I think that when we look at a usage like that, we are sort of looking at it in isolation, where there are first-order consequences that might be 90% good. Then we get second-order consequences that might be a little less good, like to collaborate at work, to have friends who are going to look out for us when our mental health is slipping into a personal apocalypse. It's just a different experience. I keep saying that a lot of what my portrait show is the messiness that it is to be human. Just because we're already talking about the robot apocalypse, I think that our best defense is to lean into what it means to be human. We can't be better at AI, at the seamless, clean, pleasing, big data set stuff. What is it that makes us human? And this is what we do as artists all the time. We say what makes me me, what makes me different, even if it's inconvenient and unpleasant. And taking that and turning that into our advantage in the world. I don't exactly know how that will come about, but it's a version of the question. I think everybody in their field has to ask themselves, which is, if AI can do what I do, then what do I do that it can't do? And how do I make that more valuable? All right. Well, let me press you on a point that you made earlier about the difference with AI, because, of course, beauty standards have been around for as long as we have art, right? I mean, it's certainly beauty, beauty ideals are obviously present in ancient Greece, for example, in ancient Egypt. What is different with AI compared to somebody going to an art gallery in the Renaissance, for example? So there's two main differences. One is that we're dealing with an internationalized standard of beauty, where as women we're supposed to have, I work a lot with the Miss Universe contestants. And it's interesting to see these apps be applied to their faces and bodies, because they're so gorgeous they're from all over the world, they should look completely different. Like I already said, they are already completely gorgeous, but they're not enough for these apps and for these filters. And what it does is it gives Miss Slovakia the same lips as Miss Jamaica, who gets the same legs as Miss Japan, who gets the same eyes as Miss Venezuela. And never before have we had a single international beauty standard being spread at such speed, where people are then taking the way that these apps modify them, and going to plastic surgeons, and trying to make our physical bodies conform to this internationalized, homogenized, single beauty standard. The second thing that's going on here, when we see in real life, in the physical world, we have two eyes, which are in two slightly different parts of our body. And that means we're always seeing slightly around objects, whereas when we're compressed onto a flat screen, or through a filter, but even just looking at a real person unfiltered through a screen, that image is still algorithmically processed, because it has to be, like something is turning me into data that the camera is interpreting and putting out an image. It's why when you take a photo with a new iPhone, versus an old iPhone, versus Android, if you can take the same photo and the image will look completely different, because algorithmic choices need to be made and how that image is processed. And the lips are always a great example of this, because these huge lip fillers have become so popular, and it's the male jaw, same things, pointy male jaw has become very popular. And it's because we're trying to compress three dimensions into two-dimensional space. And in order to look like we have lips or the ideal male face on a screen, we actually have to exaggerate that third dimension, because it's been flattened by the two dimensions of the screen. And we're prioritizing this flat self, this flattened self, because with the massive lips, some people think that this looks really great from the front, but nobody thinks the side view of the duck lips is a desirable side effect of this. But because we've so prioritized that flattened screen image, we're no longer caring if we don't look good in real life, because as long as we look good on Instagram, as long as our LinkedIn profile is popping. It's a bizarre idea. It never occurred to me at all before. So, what are the tangible differences if we compare what's going on right now to, I don't know, we could pick any period of history where there are still beauty fans, and they may be bizarre. Maybe we could talk about foot binding in China or we could talk about face tattoos within Japanese women, and all sorts of weird and wonderful fads within beauty. Is there something that worries you more about AI that's kind of special in some way? Yeah, it's the speed in the scale. It's also the way that it interacts with the market, where Tina Fey has a funny quote where she's basically saying, "Oh, I wasn't pretty growing up, so I had to develop a personality." And when I grew up, if you weren't pretty, that was it. But now there's this feeling that you should change it. That, of course, she's making a funny point within this, because obviously it's not so binary. Now it's like, if you don't have this perfect body that AI has designed, which like I said, it's not just Western. It is a conglomeration of body parts that do not traditionally exist together on a single physical body. But like, let's say you wanna get that body. You can buy the lip fillers. You can get the plastic surgery on your face, on your nose. You can have the breast implants of your man. You can have the facelift. You can have the jaw surgery. It's almost like the technology and the plastic surgery technology, the injectable technology. A lot of this coming from, I would say the medical field, but there's also so much scandal going on right now of people not having their licenses and injecting basically cement from Alibaba into people's faces, where there's like very loose regulation depending on the state in the US or the country that you're in. That these medical spas are growing like crazy. And very poorly regulated. And people are going to them for what they're thinking of as like a facial, but it involves procedures and modifications to our body that are very much in need of professionalized medical care. Because if things go wrong, they can go very wrong. And I'm sorry, I got a little bit off on a tangent there because I was getting so passionate about the cement being injected into people's lips. I would feel passionate about it. If somebody tried to inject cement into my lips, so I think that's completely allowable. Yes, yeah, yeah. And I think you're asking more about, you know, what has changed about this. And I'm just trying to distill the pressure to actually change ourselves is more pervasive, especially with men. We were seeing, there was an article in the Wall Street Journal about the increase in facelifts among tech bros. And how, because there's such a cult of youth in tech, Peter Tiel once said, you can't hire anyone over 30. So many facelifts, necklifts, eyelids have increased 50%. And these are not cheap things. These are $150,000 facelifts. Eyelifts are costing $65,000. And it's men. It's men who are getting these plastic surgeries because this algorithmic ideal of a bunch of VCs, they did some analysis. And they're like, yes, young people form better companies. And so it's only invest in young people. And the trend of needing to look a certain way instead of just do a certain thing is, like I said, it's hitting our physical bodies. And it is not just teenage girls on tech talk. It is also tech bros and Silicon Valley. Yeah, interesting. Now, let's-- why don't we talk about how this could interact with race? Because obviously, there are different races. And America, in particular, where you're from is very much a-- well, it's a melting pop, but it's also diverse. And I can imagine that if there's some-- is there some sort of pressure for these beauty standards to somehow be averaged across different racial groups? In other words, maybe everyone from different racial groups kind of feels like they need to conform to some sort of mythical average. Is there some sense in which that's true? I love the term you just invented the mythical average, because that is a great way to put this. It's not just a Western standard. It is this sort of Frankenstein idea of what the-- at least for the female body, what is supposed to all exist together within a single-face and body. And I teach in China, and my students there, when I try to talk to them about this, they're like, of course, we face too. And a lot of the phones in China automatically do this. The-- Wow, OK. When you get a family portrait in Korea, it automatically does this. You have three generation of women, all who will have the skin of a 25-year-old, and the final photo. What is different culturally about this is the openness and really the shame around it as well. Whereas in my students in China are like, yeah, of course, we do this. There's less of a tradition of wanting to look and be an individual and a collective as culture. Whereas in America, the history is more celebratory of standing out, of looking different. And what's happening now with these apps is there's more of a move towards that the collectivism. I'm not even sure if this ideal faces that pretty. It's just the one that everybody has. And the desire is not so much to be pretty as it is to fit in, to be like other people, to risk-- to not risk standing out in a negative way. And so therefore, going towards this mythical average or whatever great term you've just referred to it as. So is there a way that we can somehow quantify the importance of this kind of problem or studies on this kind of issue? Yeah, absolutely. A lot of them having to do with mental health and body dysmorphia. So there is studies show that I, lessons who spend more than three hours day on social media are at double risk of experiencing symptoms of depression and anxiety. And the cases of teen suicide we had mentioned before, there's also 21 articles found that intensive social media use was related to body satisfaction, low esteem, but also eating disorders. And I think as a society, we have a general problem with quantifying things like depression and anxiety. But this is creeping into statistics of body dysmorphia, of teen suicide. Much more measurable things in the medical field because they are diagnosable conditions. And they result in death sometimes. And so to be able to actually start putting numbers to this, I think is really important, there's been a lot of research. And this is why I say that I believe it's the tobacco of our generation. I think medical science knows that this is very bad for our mental health. I think these companies know that it's very bad for our mental health. As a user of these social media and these tools, I know it's bad for our mental health. Yet, I've not stopped smoking. And I mean, that metaphorically, I mean, I've not stopped using Instagram. Parents are having a hard time figuring out when their kids should be allowed to use these apps. And despite all of that, there's not much really being done about it. Yeah, Gino Gretchen, when I first started discussing this issue, to be honest, I kind of thought that it sounded a bit trivial, but you've completely convinced me, just because of how much people do consume social media. I'm far more time spent on that than reading books on magazines or watching TV. I mean, it's a very, very important source of influence, is it not? And I do want to make sure that we're expanding thinking about social media to include LinkedIn, to include YouTube. And not just Instagram, I'm trying to think of Twitch as another example. What social media is, is always constantly evolving and changing the platforms are different. But especially when we think back to the pandemic, the amount of people that we were seeing, even today, I'm in Utah right now. I've had nine Zoom calls today. And I've seen zero people in person. So again, I'm not like a recluse. It's just the amount of people that I actually interact with on a screen is significantly more than the people that I will interact with throughout the course of a day. And like I said, the Zoom also has a set of filters. Google Meet has a set of filters. There may be not as extreme as a face tune, but they are changing how we look. They are filtering us. They are AI-driven. They are algorithmically processed. And there is a reason why people love to use them. Because when we don't use them, we look so weird. Because everyone else on that Zoom call is probably has that automatic setting turn on that does touch up the appearance. It's such a weird thing. It's kind of creeping up on us. Because I don't think I've ever seen this kind of automatic face tuning in on a Zoom call. But you're saying that's coming in now, right? Oh no, you've definitely seen it. You probably just haven't even noticed it. There's a little feature called Touch Up My Appearance. And it does exactly what it says. It touches up the appearance. I'm seeing it increasingly on LinkedIn, to be honest, where people want professional headshots. And so there are these apps where you feed it a bunch of images of you at parties or on vacation. And then it makes a professional headshot. Wow. But within that, it's not just like putting a blazer on you, right? It's changing your face as well to look a certain way. So I think you've articulated beautifully what this problem is. But could you say something about how you see possible steps to address these kind of issues? So I think one of the biggest things we need to do is find ways of talking about it. I particularly wanted to use Facetune and Filters as a conversation piece because it's so prevalent and it is used very haphazardly. So in my work what I do is I find ways of making that more visible and therefore more understood. I think education and visibility is a huge aspect in all of this. The second thing is I think it's important that when we do talk about AI in the medical field that we explore the possible negative implications of it as well, both in something like this where it causes mental health challenges but also in the set of assumptions it might be making that I mean believe me I'm all for AI and medicine I want it to identify my cancerous moles all day. There's so many incredible implications of this but in a lot of fields what we've done is sort of raced you know jumped into the deep end very quickly without considering where the negative implications might be and I'm not an expert in the medical field but I do hope that people on your podcast are considering what possibly could be the flip side of this technology. Well I'm so glad to have had you on the podcast because I think even just as an artist I think you are almost inevitably going to become increasingly relevant right as people becoming more and more aware of these kinds of issues. I mean we are still you could say in the early days of these kind of problems so that's a thrill for me but let me ask you actually before I ask you my last question Gretchen let me just ask you which of the famous tech bros had a facelift? Zuckerberg does not look fully human does everyone says that is true. It does look like he's had some serious Botox doesn't he? He listens to you. The sort of thing you should never say on on something that's going to get indexed by the world but the I did see Zuckerberg in person once and he did look waxy. He could have been crygently preserved in like 1972. I wouldn't be too surprised. Yeah I'm so there is I think it was a wired article or maybe it was a box article and we can put it in the the description I'll send it to you that's particularly looks at this male jawline thing and believe me the people who've had this done the amount of protection and shame around it no one no one who's done this will admit it and that is one of the differences between maybe Western and Eastern culture for to generalize is people face tune and plastic surgery just enough so that you can't tell that they've done it and if you've gone there's going too far and then being called out and then there's this like weird shame culture around it even though it is so prevalent and it is something that with women I have seen start to shift where people who've had really good plastic surgery done aren't hiding it I'm the mom of the Kardashian family who now looks just like one of her daughters like obviously she got plastic surgery she looks 100% different from one week to the next and that's an interesting culture too when we get into people being open about it or really considering when people are and are not open about it I think says a lot about the culture that we're living in today and any plastic surgeon will tell you the NDAs that are signed in in this industry are very very litigious all right well look we are the medical AI podcast and I'm going to ask you Gretchen since you are an AI you have a good AI background yourself what's your favorite example of a medical AI system so because I am not a medical professional and many of your listeners might be really horrified to hear this I I absolutely love talking to any of the AI systems about my symptoms and having it provide basic medical information for me so I'm going to say chat GPT is my favorite medical AI system because I think the amount of people who are triaging themselves and getting basic information about like health low iron you know oh there's hair growing out of that mole it's unlikely to be cancerous I don't know how much of a problem this is causing but there's the amount of times that AI has made me get gotten to me to a place where I can sleep more soundly whereas back in the days of web ND and just googling symptoms like you you're always pregnant with brain cancer no matter what and I find AI to be very like to not be as alarmist about many of my daily symptoms I think that's an excellent point Gretchen it's been such a thrill having you on thank you so much and all the best of luck with your coming exhibitions thank you so much Felix and thank you so much to your listeners for going through this non-traditional version of this topic thank you thanks so much but Gretchen bye-bye thanks for listening for world-class coaching and consultancy in health tech check out coolcoaching.co.uk you