Abstract
Language barriers affect 27.3 million U.S. residents with non-English language preference, yet professional medical translation remains costly and often unavailable. We evaluated four frontier large language models (GPT-5.1, Claude Opus 4.5, Gemini 3 Pro, Kimi K2) translating 22 medical documents into 8 languages spanning high-resource (Spanish, Chinese, Russian, Vietnamese), medium-resource (Korean, Arabic), and low-resource (Tagalog, Haitian Creole) categories using a five-layer validation framework. Across 704 translation pairs, all models achieved high semantic preservation (LaBSE greater than 0.92), with no significant difference between high- and low-resource languages (p = 0.066). Cross-model back-translation confirmed results were not driven by same-model circularity (delta = -0.0009). Inter-model concordance across four independently trained models was high (LaBSE: 0.946), and lexical borrowing analysis showed no correlation between English term retention and fidelity scores in low-resource languages (rho = +0.018, p = 0.82). These converging results suggest frontier LLMs preserve medical meaning across resource levels, with implications for language access in healthcare.