Medical visual question answering (VQA) is a crucial task in clinical AI, yet its evaluation has so far centered almost exclusively on English, limiting its relevance to linguistically diverse patients and clinicians. Recent multilingual medical VQA benchmarks show that large vision-language models (LVLMs) degrade in non-English languages, but lack a fine-grained analysis of how cross-lingual variation affects the distinct capabilities that medical VQA requires. To this end, we construct a multilingual medical VQA benchmark over eight languages, organized into four representative scenarios that isolate the core capabilities medical VQA requires. Evaluating five open- and closed-source LVLMs, we find that cross-lingual degradation is not uniform but highly scenario-dependent. We therefore propose MedVL-XLRepE, a training-free scenario-aware representation engineering method, leveraging LVLMs' superior English medical VQA capability to steer non-English representations toward their English counterparts at inference time. Across three LVLMs and eight languages, MedVL-XLRepE consistently mitigates cross-lingual degradation, with gains of up to 6.33\%.
Representation engineering offers a lightweight means of controlling language-model behavior by modifying intermediate hidden states, but its direct application to Mixture-of-Experts (MoE) models introduces a structural mismatch. We first verify this failure mode through a series of empirical studies and find that preserving clean routing substantially recovers steering performance and that routing is more sensitive to semantic content than to behavioral changes under controlled content. Motivated by these findings, we introduce RARE, a router-agnostic representation engineering framework for MoE language models. RARE projects arbitrary behavioral perturbations onto the null space of the router matrix, thereby removing router-visible components, and further corrects routing drift propagated to selected downstream layers. To decide the best perturbation estimator in this framework, we evaluate five estimators on six heterogeneous open-weight MoE models across three steering scenarios: harmfulness, truthfulness, and factual editing. On harmfulness steering, RARE reaches an average attack success rate of 53.3% while retaining 67.8% MMLU accuracy, yielding a stronger aggregate effectiveness--utility trade-off than baselines. It further improves average TruthfulQA MC1 accuracy from 41.0% to 58.6% and CounterFact efficacy from 16.8% to 96.3%. These results support routing consistency as an important architectural consideration for adapting representation engineering to MoE models.
Modern Large Language Models (LLMs) rely on extensive safety alignment, yet the mechanistic basis of refusal remains opaque. In this work, we investigate whether safety compliance is a deep semantic decision or a manipulable linear feature. We introduce Contrastive Logit Steering (CLS), a zero-optimization framework that isolates the "refusal direction" by contrasting hidden states derived from safe and unrestricted system prompts. Unlike representation engineering methods that intervene on internal activations, CLS operates directly on the output distribution, serving as a diagnostic probe for alignment fragility. When coupled with prefix injection to bypass initial refusal reflexes, this method induces a phase transition where guardrails collapse. Our experiments on 7 model families reveal that safety implementation is architecturally deterministic. While models like Llama-3.1 exhibit a "Late Decision" topology that is easily bypassed by CLS (reaching 95% ASR in approximately one second), others like Qwen-2.5 demonstrate "Early Divergence" by integrating safety mid-computation. Direct comparison with established activation-level steering methods shows that CLS achieves substantially higher attack success rates on Llama 2 (73% vs. 22.6%) and Qwen 7B (91% vs. 79.2%), demonstrating that logit-level intervention exposes alignment vulnerabilities that hidden-state methods underestimate. Beyond attacks, we show that this linearity enables bidirectional control: inverting the steering vector "hardens" models against jailbreaks without retraining. Our findings suggest that current alignment techniques create a steerable "safety axis" that serves as both a critical vulnerability and a precise primitive for defense.