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Safe clinical deployment of Large Language Models (LLMs) requires not only high accuracy but also robust uncertainty calibration to ensure models defer to clinicians when appropriate. Our paper investigates how social descriptors of a patient (specifically sexual orientation and religious affiliation) distort these uncertainty signals and model accuracy. Evaluating nine general-purpose and biomedical LLMs on 2,364 medical questions and their counterfactual variants, we demonstrate that identity markers cause a &quot;calibration crisis&quot;. *Homosexual* markers consistently trigger performance drops, and intersectional identities produce idiosyncratic, non-additive harms to calibration. Moreover, a clinician-validated case study in an open-ended generation setting confirms that these failures are not an artifact of the multiple-choice format. Our results demonstrate that the presence of social identity cues does not merely shift predictions; it affects the reliability of confidence signals, posing a significant risk to equitable care and safe deployment in confidence-based clinical workflows.

ACL 2026

Calibrated? Not for Everyone: How Sexual Orientation and Religious Markers Distort LLM Accuracy and Confidence in Medical QA

### Welcome to The 63rd Annual Meeting of the Association for Computational Linguistics (ACL 2025)

Message from the General Chair: 
*It is my great pleasure and honor to welcome you to the 63rd Annual Meeting of the Association for Computational Linguistics (ACL 2025), held in beautiful Vienna, Austria, from July 27 to August 1, 2025. ACL2025continues our field’s tradition of excellence in scholarship, innovation, and inclusivity, and I am deeply grateful to the many volunteers who have worked tirelessly to bring this event to life.* 
[Read more](https://drive.google.com/file/d/1GI_hvOpjswAuYdUTromfeDiPpCcqidwg/view?usp=sharing)

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ACL 2025

Welcome to The 63rd Annual Meeting of the Association for Computational Linguistics (ACL 2025)

Safe clinical deployment of Large Language Models (LLMs) requires not only high accuracy but also robust uncertainty calibration to ensure models defer to clinicians when appropriate. Our paper investigates how social descriptors of a patient (specifically sexual orientation and religious affiliation) distort these uncertainty signals and model accuracy. Evaluating nine general-purpose and biomedical LLMs on 2,364 medical questions and their counterfactual variants, we demonstrate that identity markers cause a "calibration crisis". *Homosexual* markers consistently trigger performance drops, and intersectional identities produce idiosyncratic, non-additive harms to calibration. Moreover, a clinician-validated case study in an open-ended generation setting confirms that these failures are not an artifact of the multiple-choice format. Our results demonstrate that the presence of social identity cues does not merely shift predictions; it affects the reliability of confidence signals, posing a significant risk to equitable care and safe deployment in confidence-based clinical workflows.

poster

It is my great pleasure and honor to welcome you to the 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026), held in San Diego, California, USA, July 2–7, 2026. ACL 2026 continues our fields tradition of excellence in scholarship, innovation, and inclusivity, and I am deeply grateful to the many volunteers who have worked tirelessly to bring this event to life.

It is exciting to see the many developments in the field reflected at our conference, such as the advancement of large language models (born out of our community) into many application directions. This is not without challenges, partly due to unsolved problems, and partly due to misuse of the technology. All this is reflected well at ACL 2026. The conference also reflects that the field is not only about advancing technology, but also the science of fundamentally understanding language and how it is use by many different speaker communities. 
[Full Message from General Chair Philipp Koehn](https://drive.google.com/file/d/1QiJFOmMjvDgsDo3i1XzlQnImxe3RU_Cy/view?usp=sharing) 
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The 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026) will take place in San Diego, California, from July 2 - 7, 2026.

Supervised fine-tuning (SFT) on long chain-of-thought (CoT) trajectories has emerged as a crucial technique for enhancing the reasoning abilities of large language models (LLMs). However, the standard cross-entropy loss treats all tokens equally, ignoring their heterogeneous contributions across a reasoning trajectory. This uniform treatment leads to misallocated supervision and weak generalization, especially in complex, long-form reasoning tasks. To address this, we introduce **V**ariance-**C**ontrolled **O**ptimization-based **RE**weighting (VCORE), a principled framework that reformulates CoT supervision as a constrained optimization problem. By adopting an optimization-theoretic perspective, VCORE enables a principled and adaptive allocation of supervision across tokens, thereby aligning the training objective more closely with the goal of robust reasoning generalization. Empirical evaluations demonstrate that VCORE achieves the strongest overall average performance, with especially clear gains on lower-capacity models. Across both in-domain and out-of-domain settings, VCORE achieves substantial performance gains on mathematical and coding benchmarks, using models from the Qwen3 series (4B, 8B, 32B) and LLaMA-3.1-8B-Instruct. Moreover, we show that VCORE serves as a more effective initialization for subsequent reinforcement learning, establishing a stronger foundation for advancing the reasoning capabilities of LLMs.

VCORE: Variance-Controlled Optimization-based Reweighting for Chain-of-Thought Supervision

For Transformer models, cryptographically secure inference ensures that the client learns only the final output, while the server learns nothing about the client’s input. However, securely computing nonlinear layers remains a major efficiency bottleneck due to the substantial communication rounds and data transmission required. To address this issue, prior works reveal intermediate activations to the client, allowing nonlinear operations to be computed in plaintext. Although this approach significantly improves efficiency, exposing activations enables adversaries to extract model weights. To mitigate this risk, existing works employ a shuffling defense that reveals only randomly permuted activations to the client. In this work, we show that the shuffling defense is not as robust as previously claimed. We propose an attack that aligns differently shuffled activations to a common permutation and subsequently exploits them to extract model weights. Experiments on Pythia-70m and GPT-2 demonstrate that the proposed attack can align shuffled activations with mean squared errors ranging from $10^{-9}$ to $10^{-6}$. With a query cost of approximately \\$1, the adversary can recover model weights with L1-norm differences ranging from $10^{-4}$ to $10^{-2}$ compared to the oracle weights.

On the (In-)Security of the Shuffling Defense in the Transformer Secure Inference

Standard tokenizers over-fragment domain terms, disrupting morpheme semantics. We characterize this representational misalignment as Structural Knowledge Collapse (SKC), where attention mechanisms fail to reconstruct coherent concepts from fragmented inputs. While existing input-centric solutions like vocabulary expansion address this, they necessitate expensive embedding retraining and neglect internal attention compositionality. To this end, we introduce Morpheme-aware KV-aggregation Attention (MorphKA), a lightweight adapter that dynamically consolidates fragments without tokenizer changes. Bypassing tokenizer retraining, MorphKA employs a dual-phase strategy, Input-Level Morpheme Aggregation (IMA) and Context-Aware KV-Aggregation (AMRF), to stabilize morpheme spans and synthesize higher-order concepts. Experiments on medical and legal benchmarks show MorphKA outperforms vocabulary adaptation baselines by 3.2--4.6%, reaching 7.9% on high-fragmentation terms. Moreover, MorphKA reduces catastrophic interference on general capabilities by 18--22% with ～80% fewer parameters than embedding retraining approaches.

Mitigating Structural Knowledge Collapse in Domain-Specific LLMs via Morpheme-Aware KV-Aggregation

While transformer models exhibit strong in-context learning (ICL) abilities, they often fail to generalize under simple distribution shifts. We analyze these failures and identify Softmax, the scoring function in the attention mechanism, as a contributing factor. We propose Scaled Signed Averaging (SSA), a novel attention scoring function that mitigates these failures. SSA significantly improves performance on our ICL tasks and outperforms transformer models with Softmax on several NLP benchmarks and linguistic probing tasks, in both decoder-only and encoder-only architectures.

SSA: Improving Performance With a Better Scoring Function

Medical consultations are intrinsically speech-centric. However, most prior works focus on long-text-based interactions, which are cumbersome and patient-unfriendly. Recent advances in speech language models (SpeechLMs) have enabled more natural speech-based interaction, yet the scarcity of medical speech data and the inefficiency of directly fine-tuning on speech data jointly hinder the adoption of SpeechLMs in medical consultation. In this paper, we propose SpeechMedAssist, a SpeechLM natively capable of conducting speech-based multi-turn interactions with patients. By exploiting the architectural properties of SpeechLMs, we decouple the conventional one-stage training into a two-stage paradigm consisting of **(1) Knowledge & Capability Injection via Text** and **(2) Modality Re-alignment with Limited Speech Data**, thereby reducing the requirement for medical speech data to only **10k** synthesized samples. To evaluate SpeechLMs for medical consultation scenarios, we design a benchmark comprising both single-turn question answering and multi-turn simulated interactions. Experimental results show that our model outperforms all baselines in both effectiveness and robustness in most evaluation settings.

SpeechMedAssist: Efficiently and Effectively Adapting Speech Language Models for Medical Consultation

The Key-Value (KV) cache introduces substantial memory overhead during large language model (LLM) inference. Although existing vector quantization (VQ) methods reduce KV cache usage and provide flexible representational capacity across bit-widths, they suffer severe performance degradation at ultra-low bit-widths due to key cache outliers that hinder effective codebook utilization. To address this challenge, we propose VecInfer, a novel VQ method for aggressive KV cache compression while enabling efficient inference. By applying smooth and Hadamard transformations, VecInfer suppresses outliers in the key cache, enabling the codebook to comprehensively cover the original data distribution and thereby reducing quantization difficulty. To facilitate efficient deployment, we design an optimized CUDA kernel that fuses computation with dequantization to minimize memory access overhead. Extensive evaluations demonstrate that VecInfer consistently outperforms existing quantization baselines across both long-context understanding and mathematical reasoning tasks. With only 2-bit quantization, VecInfer achieves performance comparable to full precision, while delivering up to $\mathbf{2.7\times}$ speedup in large-batch self-attention computation and $\mathbf{8.3\times}$ reduction in single-batch end-to-end latency on Llama-3.1-8B with a 196k sequence length.

VecInfer: Efficient LLM Inference with Low-Bit KV Cache via Outlier-Suppressed Vector Quantization

Applying language models (LMs) to tables is challenging due to the mismatch between the two-dimensional structure of tables and the one-dimensional inputs expected by LMs. This mismatch forces linearization, making LMs particularly sensitive to irrelevant cells. Subtable selection mitigates this challenge by isolating question-relevant content prior to answer generation. However, existing approaches either rely on independent row or column selection, failing to capture cross-row and cross-column dependencies, or attempt global reasoning and face challenges similar to holistic table QA under noisy contexts. We propose *PieTa* (Piece of Table), a divide-and-conquer subtable selection framework that progressively aggregates locally selected evidence without requiring explicit global reasoning. *PieTa* uses an iterative, window-based multi-resolution process to construct compact subtables that capture global dependencies while limiting LM exposure to irrelevant content. Extensive experiments demonstrate that *PieTa* consistently outperforms prior subtable-based and holistic table QA approaches.

Piece of Table: A Divide-and-Conquer Approach for Selecting Subtables in Table Question Answering

Decision-making is a cognitively intensive task that requires synthesizing relevant information from multiple unstructured sources, weighing competing factors, and incorporating subjective user preferences. Existing methods, including large language models and traditional decision-support systems, fall short: they often overwhelm users with information or fail to capture nuanced preferences accurately. We present Decisive, an interactive decision-making framework that combines document-grounded reasoning with Bayesian preference inference. Our approach grounds decisions in an objective option-scoring matrix extracted from source documents, while actively learning a user's latent preference vector through targeted elicitation. Users answer pairwise tradeoff questions adaptively selected to maximize information gain over the final decision. This process converges efficiently, minimizing user effort while ensuring recommendations remain transparent and personalized. Through extensive experiments, we demonstrate that our approach significantly outperforms both general-purpose LLMs and existing decision-making frameworks achieving up to 20% improvement in decision accuracy over strong baselines across domains.

 Decisive: Guiding User Decisions with Optimal Preference Elicitation from Unstructured Documents

Despite recent progress, the reasoning capabilities of large multimodal language models (MLLMs) remain fundamentally constrained by static supervision, where fixed prompts, rules, or reward models provide non-adaptive guidance throughout training. Such static signals are often sufficient to enforce output formats, but fail to shape the underlying reasoning process, leading to brittle generalization and performance saturation in complex decision-making tasks. We propose \textbf{Evo-PI}, a principle-centric learning framework that treats reasoning principles as explicit, language-based supervision signals that can be generated, evaluated, and iteratively evolved. Instead of relying on fixed rewards, Evo-PI enables a co-evolutionary loop in which principles guide model reasoning, while model behaviors in turn refine the principles that supervise them. This dynamic alignment mechanism allows supervision to progressively adapt to the model’s reasoning deficiencies. We instantiate Evo-PI in medical visual question answering as a high-stakes testbed requiring structured visual–textual reasoning. Across eight benchmarks and multiple model backbones, Evo-PI consistently improves reasoning accuracy, achieving gains of up to 24.6%. Our results suggest that evolving principle-guided supervision offers a scalable and general paradigm for training expert-aligned reasoning in multimodal language models.

Evo-PI: Aligning Medical Reasoning via Evolving Principle-Guided Supervision

Large language model (LLM) web agents are increasingly used for web navigation but remain far from human reliability on realistic, long-horizon tasks. Existing evaluations focus primarily on end-to-end success, offering limited insight into where failures arise. We propose a hierarchical planning framework that analyzes web agents across three layers (i.e., high-level planning, low-level execution, and re-planning), enabling process-based evaluation of reasoning, grounding, and recovery. Our experiments show that structured Planning Domain Definition Language (PDDL) plans produce more concise and goal-directed strategies than natural language (NL) plans, but low-level execution remains the dominant bottleneck. These results indicate that improving perceptual grounding and adaptive control, not only high-level reasoning, is critical for achieving human-level reliability. This hierarchical perspective provides a principled foundation for diagnosing and advancing LLM web agents.

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VCORE: Variance-Controlled Optimization-based Reweighting for Chain-of-Thought Supervision

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