Wearable VLM pipelines promise continuous multimodal assistance from egocentric visual capture: a user asks a task-driven question about the surrounding scene, and the system uses compact visual tokens to support language reasoning. The challenge motivating this work is that the same egocentric evidence needed for useful assistance can also reveal private attributes about the wearer or nearby bystanders. We investigate this as a joint privacy-utility problem for split VLM inference, where visual encoding occurs within a trusted device boundary but intermediate visual tokens may be transmitted to downstream reasoning components. This exposes an understudied leakage surface: even when final textual responses are benign, external attackers or untrusted downstream components can recover private attributes from transmitted visual tokens. To evaluate this tension, we construct a paired privacy-utility benchmark with 3,221 image-question records, each paired with a utility question and privacy labels covering location, income, sex, and interests. We further propose Token-Guided Attribute Privacy (TGAP), a pre-LLM token disentangler that learns a residual transformation of visual tokens before they leave the trusted boundary. TGAP combines utility preservation, identity regularization, semantic privacy suppression, and image-driven representation suppression, avoiding the utility loss caused by coarse hard or attention masking. On the benchmark used for source-model evaluation, TGAP reduces privacy accuracy from 56.7\% to 7.4\%, a 49.3\% absolute drop, while maintaining relaxed utility at 74.4\%. These results suggest that securing the compact token interface is a practical path toward privacy-preserving wearable multimodal AI.

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