The complex story of Dr James Barry was initially presented to me in an arguably oversimplified package. The first female doctor, forced undercover by a patriarchal and unaccepting society, to become an incredibly talented and highly esteemed military surgeon, all the while maintaining secrecy until the end.

As a devout fan of George Eliot, Ellis Bell and the film She’s the Man, my feminism was immediately piqued.

I thought it would be an excellent idea for an article, publicising a strong female role model to be respected and admired. When I found out that Barry might be connected to Barts, such an article became irresistible. I was thus incredibly surprised when my research revealed Dr James Barry was an incredibly talented individual whose surgical skill and public health impact was hidden behind a constant gender debate about which the deceased could have no say. Furthermore, the surgeon connected to Barts was in fact a Sir James Berry, who was born a man, died a man and remained a man in between.

Margaret Ann Bulkley was born in the year 1789 in the town of Cork, Ireland. Her father was placed in a debtor’s prison when Margaret was around 15 years old, leaving her mother, Mary Ann to beg help from her estranged brother in 1804. The latter was a painter by the name of James Barry who would go on to look after them. More importantly, James would go on to introduce Margaret to his friends that moved in radical circles. Among these included the writer William Godwin, widower of the late Mary Wollstonecraft and who was famously vocal on gender equality. Additionally, General Francisco Miranda, a Venezuelan revolutionary exiled to London and owner of a library Margaret frequented. The decision in November 1809 Margaret made to journey to take up a place at Edinburgh medical school as James Miranda Steuart Barry indicates the influence these individuals had on her was not inconsiderable. Henceforth to her death they would maintain this identity as a man.

The public interest in Dr James Barry was largely gossip and speculation until the 1950s when the historian, Isobel Roe, gained access to the military records of the army. The piece of evidence connecting Margaret Ann to James was a letter on 14 December requesting any letters addressed to Margaret to be forwarded to Mary Anne. The letter, signed James Barry, had ‘Miss Bulkley’ indiscreetly scribbled on its envelope by the dispatching solicitor allowing for the final puzzle piece connecting Barry’s two lives. When in Edinburgh, Barry’s short stature, unbroken voice and delicate features continually aroused suspicion with most blaming youth or a delayed puberty. The University Senate would even attempt to bar Barry from sitting the final exams, believing them to be 12 rather than 22. They may have succeeded had not the Earl of Buchan, a friend of Barry’s tutor, intervened and persuaded them to relent. Barry would qualify as Medicinae Doctor in 1812.

Almost immediately, Barry signed up to be an army surgeon and spent a few years in Britain prior to being posted to Cape Town in 1815, where they would serve for 14 years. Through Lord Buchan, Barry had a letter of introduction to the Governor Lord Charles Somerset. Their friendship began when Barry successfully treated Somerset’s sick daughter, establishing a trust that would last a lifetime. This closeness would arouse suspicion of homosexuality, then very illegal, when an accusation appeared on a bridge post in 1824. Many suspect that if anyone knew Barry’s secret, the most likely candidate was Somerset whom Barry described as “my more than father – my almost only friend,” but this remains speculation.

In terms of medicine, Barry’s impact was remarkable.

They performed the first successful documented Caesarean section on a lady called Mrs Munnik, saving the life of both mother and child. The infant would be christened James Barry Munnik and the name trickled down to the later Prime Minister of South Africa, J. B. M. Hertzog. Much of his legacy remains in public health, advocating improvements to sanitation and living conditions, particularly for the enslaved, imprisoned and mentally ill. Barry would make the recently invented smallpox vaccine available to Cape Town some 20 years before it was widely used in Britain. From Cape Town they travelled widely, maintaining the same surgical talent and passion for health and sanitation reform. In Crimea, Barry would visit the famous Scutari field hospital where they would meet Florence Nightingale. Despite their similar interests Nightingale would describe Barry as a “hardened creature” and a “brute”; by then, their abrasive personality was no secret.

Barry would die of dysentery in 1865, with his secret yet undiscovered. They had repeatedly voiced a wish that ‘strict precautions should be adopted to prevent any examination of his person’ and that their body should be ‘buried in [the] bed sheets without further inspection.’ The charwoman, Sophia Bishop, obeyed no such instruction and remarked to Major McKinnon that this was a woman. She even claimed that Barry had likely given birth before, identifying stretch marks and citing her own experience of 9 births as expertise enough for her observation. Yet the death certificate that was signed acknowledged Barry as a man, and they were hurriedly buried in Kensal Green cemetery. The army hushed up the affair either through shame or lack of interest. Remarkably, the latter option seems most likely following a letter to McKinnon from the Registrar General asking for confirmation or denial of Barry’s sex. McKinnon replied, “it was none of [his] business whether Dr Barry was a male or female” following it up that “I thought it as likely that he might be neither, viz. an imperfectly developed man.” Bishop had hoped that she might be able to bribe McKinnon into keeping her mouth shut and his nonchalance must have been not only frustrating but immensely surprising.

The ambiguity that ensued has led to Barry being lauded by both the feminist and transgender community in opposition. EJ Levy wrote her biography of Barry using exclusively female pronouns, depicting Barry as a woman forced undercover by ambition but retaining her feminine sense of self. This position was romanticised in numerous dramatic recreations of Barry’s life. In the Cape, Barry would be embroiled in a pistol duel with Captain Cloete for alleged intimacy with the latter’s wife. Following a non-threatening gunshot injury he would insist on dressing his own wound. When this duel was portrayed in a 1919 play, starring the actress Sybil Thorndike as Barry, Thorndike would burst into tears upon injury. This ultimately reflects of the liberties of interpretation and the enraging inaccuracies of gendered behaviour. Considerable speculation has rested on the possibility that Barry had Androgen Insensitivity Syndrome. Their Edinburgh thesis on femoral hernias, which can result from undescended testes, perhaps lends weight to this idea.

The consensus has come to acknowledge the fact that Barry upon assuming a male identity never indicated they wished to be known as anything but.

Describing Barry as a woman in disguise or transgender is to impose our own comparatively straightforward labels on a remarkably complex picture.

This seems immoral to do for someone who wanted only to be remembered for their impact in medicine.