Either you use biometrics, like liveness testing or face id or fingerprint testing, or social validation like decentralized web of trust or private moderation (account controls) or state methods like fines and criminal convictions.
Biometrics rely on social methods eventually like we trust Apple because we can sue them or the government will harangue them. Liveness testing is only as good as your sensor and image vs generation and replay in the arms race.
And iterated social games like punishment are only as good as people want to invest energy into it.