Raffaella De Vita, professor and associate department head in the Department of Biomedical Engineering and Mechanics in the College of Engineering, has been awarded a National Science Foundation (NSF) award to study the biomechanics of gender affirming surgery. De Vita aims to improve gender affirming surgery by providing the first scientific-based data for surgeries that alter the genitalia of individuals to affirm their gender identity.

In recent years, the United States has experienced profound efforts to end discrimination against transgender people, including a 2021 executive order by President Joe Biden. Health care resources that are specific to the needs of transgender people have increased, according to the advocacy group Human Rights Campaign, with more insurance companies covering hormone treatments and gender affirming surgeries.

New guidelines have been recently released to educate medical providers about transgender health issues, as referenced in the book “Comprehensive Care of the Transgender Patient,” by Cecile Ferrando, who is collaborating with De Vita on the project. However, De Vita noticed a lack of engineering research addressing the unique health care needs of this marginalized group and wanted to contribute through her expertise.

Thanks to the award from the NSF’s Boosting Research Ideas for Transformative and Equitable Advances in Engineering (BRITE) division, De Vita will conduct mechanical testing on human tissue in the Soft Tissue Research: Experiments, Theory, and Computations by Hokies (STRETCH) Lab. She aims to fully characterize the mechanical properties of tissue that are crucial for the success of gender affirming surgeries. As the sole principal investigator for the project, De Vita will develop novel mathematical and computational models to capture both the similarities and differences between genitalia of those assigned male at birth and those assigned female at birth. 

Portrait of Raffaella De Vita in her lab, sitting on a stool
Raffaella De Vita in her lab. Photo by Peter Means of Virginia Tech.

“Through research, outreach, and educational efforts, I hope to spur advancements in health care for the often-neglected transgender community,” De Vita said. “I hope this project will be the much-needed step toward building a more inclusive, equitable, and diverse academic environment at Virginia Tech. I am committed to building gender equality and reducing disparities in health care access in the United States through my research.”

De Vita conducts research on characterizing the mechanical properties of soft biological systems by integrating advanced theoretical, experimental, and computational methods. Throughout her years of research, she has significantly contributed to the study of pelvic floor biomechanics, an emerging field that has been historically under-researched despite a growing public health need.

"Dr. De Vita tasked me and some other students in our lab with finding previously published research on the mechanics of transgender surgery, or previous research into how this surgical procedure was developed,” said Justin Dubik, engineering mechanics doctoral student in BEAM. “How little we could find speaks volumes to how people in the LGBTQ+ community have been treated historically. Transgender surgical procedures weren't developed by the medical community as a whole, but rather were developed by brave individuals who were frequently providing care only on special request or in secret. It's long overdue that the scientific community does work to make these procedures safer and more successful." 

Portrait of Raffaella De Vita, in a green sweater, in her lab where she mentors students, pictured, as they look at a computer screen
Raffaella De Vita conducts research alongside students in her lab, providing multiple opportunities and mentorship for them. Photo by Emily Roediger of Virginia Tech.
Portrait of Justin Dubik in front of a blue-gray screen in the STRETCH Lab.
Justin Dubik is one of De Vita's students in the STRETCH Lab and is working alongside her on this research. Photo by Peter Means of Virginia Tech.

Building on De Vita’s extensive research in biomechanics, this project will use advanced numerical techniques to reduce the computational complexity of numerical simulations for gender affirming surgeries. Current computational models, such as finite element models, are too expensive, requiring significant time by surgeons to plan gender affirming surgeries, De Vita said. She aims to simplify the computational models and reduce the time needed to obtain useful information for surgery.

“This work is incredibly important for trans, nonbinary, and gender nonconforming communities,” said Ashleigh Bingham, director of the LGBTQ+ Resource Center in the Cultural and Community Centers of Virginia Tech. “While many members of these communities may not seek out medical or surgical transition, the need for more efficient and successful gender affirming surgeries far surpasses existing options. This is especially true of the current financial burden which accompanies these procedures, resulting in long and often painful delays in the individual’s transition. While some advances have been made in favor of gender affirming health care, it’s important to remember that poverty, homelessness, and unemployment for trans folks exceeds that of their cisgender counterparts due to institutional oppression and historical discrimination. If De Vita’s work is able to make these services more accessible to the greater trans community, it will save thousands of lives.”

These computational tools could lead to the development of novel engineered tissues and guidelines for gender affirming surgeries. Surgeons could use the tools to decide which tissue size, type, and composition would lead to a better outcome in surgery. This could guide development of tissue-engineered grafts, rather than autologous tissue, resulting in more satisfying results. Autologous reconstruction uses skin or fat tissue, called a flap, in some gender affirming surgeries and can be a complex procedure.

“I hope this project can promote gender diversity and equality in medical research while also radically changing the long-standing vision of binary genders in the biomechanics community,” said De Vita. “I want to contribute to normalizing and asserting LGBTQ+ presence and belonging in engineered spaces.”

Earlier this year, De Vita was awarded the Sally Bohland Award for Exceptional Leadership in Access and Inclusion by Virginia Tech to recognize her efforts in modeling and fostering an accessible and inclusive culture on campus. She was also elected this year as a Fellow of the American Institute for Medical and Biological Engineering (AIMBE).

De Vita earned her bachelor’s degree in mathematics from the University of Naples II and completed both her master’s degree and Ph.D. in mechanical engineering at the University of Pittsburgh.

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