The Physician, Military Officer, and Public Health Advocate who was Born a Woman and Lived as a Man.
One of the most forward-thinking public health professionals in the pantheon of British physicians is a man who is rarely mentioned. Some think he should be nominated for the title “The Father of Public Health,” while others think his historical record should remain sealed. The crux of the problem? The good doctor hoodwinked the University of Edinburgh, the British Military, and London’s high society for over 50 years. Dr. James Barry was born female but lived his life as a man.
Margaret Bulkley was assigned female when she was born in Cork around 1789. She was the second child to a successful shopkeeper, Jeremiah and his wife, Mary Ann, who provisioned the great ships in Merchant’s Quay. They led a comfortable, even fashionable life until Irish clashes with the British resulted in political subjugation. Growing anti-Catholic discrimination shuttered the shop and crippled the family’s fortune. But not before a personal tragedy befell Margaret. She was raped by a visiting uncle and delivered a child, a girl they named Juliana, in 1803. The family of five sank into poverty aided by the spending of the last of their fortune by Margaret’s profligate father and brother. They both eventually turned to crime and spent the rest of their lives in and out of prison. In 1804, her father was in debtor’s gaol in Dublin when Margaret, her mother, and her daughter (whom she called aunt and sister to anyone who didn’t know the truth) fled to England.
Mary Ann Bulkley’s brother, James Barry, was a semi-celebrity artist living in London. Despite the dire circumstances of his sister and niece, James Barry, known to be surly, refused them financial or material aid, seemingly due to snobbery and perhaps in retribution for her lack of familial contact with him during the prior 40 years when she was well-off. They went back to Ireland. Prospects for gainful employment of either woman were slim and neither were trained or experienced in work. Margaret had recently encouraged her penniless brother to join the military stating, “Was I not a girl I would be a soldier!” – an opportunity closed to females. But several months later, in 1806, they received news that James Barry had died. Mary Ann, leaving little Juliana with friends in Ireland, (never again to be seen by her biological mother) returned to London with Margaret to take ownership of her brother’s estate.
What proved to be even more beneficial than the modest financial inheritance, was their new acquaintance with James’ intelligent, progressive, and accomplished network of aristocratic friends in London. Several would be instrumental in the disappearance of Margaret Bulkley and the rebirth of James Barry including General Francisco de Miranda, a statesman and revolutionary preparing to liberate Venezuela, Dr. Edward Fryer, a physician and scholar who tutored Margaret so that she could qualify as a governess, and the Earl of Buchan, a wealthy patron of the arts; all of whom were liberals in favor of the education of women. Besides their extensive personal libraries for Margaret’s education, they also provided aristocratic references that gave credence to her credentials and her reputation.
Somewhere along the way, there occurred a switch in the plan from future governess to future physician. History is mute and historic documents absent concerning the conception of the plan for Margaret to pursue medicine as a path to family security and independence. It is thought that Margaret so convinced these men of her passion and her capability to succeed that they encouraged her ambition despite one colossal impediment: women were not admitted to medical school. The plan was that, if Margaret could play a man for three years, she could obtain her degree and then move her family to Venezuela where she could assist General Miranda and practice medicine as a woman. However it had come about, Margaret Bulkley was never heard from again and the new James Barry (calling himself the artist’s nephew) was born. With the help of his friends, he was admitted to one of the finest medical schools in the western world, the University of Edinburgh.
At the start of medical school, James understated his age on official documents in order to account for his physical immaturity. This backfired when he finished medical school less than three years later, and was declared too young to sit for the final examination. The Earl of Buchan, a patron of the university, interceded on James’ behalf clarifying that the university had no stated minimum age for graduation. James passed the examination, wrote and orally defended his thesis entirely in Latin, and became one of the few medical students who graduated from the prestigious school, at that time estimated to be only 20% of each class. James Barry became a doctor – the first woman to have graduated from the University of Edinburgh School of Medicine!
Just prior to his graduation, General Miranda was arrested as a traitor and imprisoned in Spain until his death in 1816. Margaret’s plan to live and practice medicine in Venezuela was no longer tenable. Her only choice, aside from coming out as a woman for no good purpose, was to continue as a man. There are no documents that tell us how he felt about that, but lots of speculation. What is not in question is his talent as a physician and surgeon and his concern for the poor, the downtrodden, and the enslaved.
James Barry MD
James was the target of taunts and rumors about his sexuality for the rest of his life. Luckily for him, the male fashion of the day can be summarized in one word, “dandy.” Effeminate frills at collar and cuff, velvet jackets in jeweled colors, and shiny pointy-toed shoes were the style of the day. Dr. Barry was always well-dressed, wore stacked heels to give himself some height, and padded shoulders to give himself some heft. He kept a white poodle named Psyche and when it died, he replaced it with another white poodle named Pysche. He was thought to be a bit odd.
After three years studying surgery at the prestigious Guy’s and St. Thomas’ Hospital in London, Dr Barry’s life took another unexpected turn: he joined the army! Again, we don’t know why he chose this path – maybe he really meant it when he said he would be a soldier if he were a boy. Perhaps he was nervous in London among people who might have known his “uncle,” or maybe he wanted to serve his country. The Napoleonic wars were ongoing and the need for qualified surgeons in the British military was high.
No one quite knows how he avoided the initial physical examination required to be admitted. Some think perhaps it was only required of those joining the lower ranks, or maybe he presented certificates of good health from private physicians at the behest of James’ loyal patron, Lord Buchan. In any case, James circumvented the examination. After three years of medical service in Britain, he was assigned his first international post to South Africa in 1816.
In international service, James came into his own. He impressed the Cape Town governor who elevated him to Colonial Medical Inspector in charge of the British colony’s entire health system. He instituted reforms to improve the care of lepers, prisoners, and asylum inmates; he improved water systems, sanitation, and vaccination coverage; he abhorred and campaigned against slavery. It is reported that he was gentle and kind with his patients, but temperamentally difficult with those who had to implement his reforms. This may have led to retaliatory rumors of inappropriate (and illegal) intimate behavior between James and the Governor. A government inquiry cleared them of the charges.
Dr. Barry rose to the rank of Army Medical Inspector, one of the most senior positions in the British Army, equal to a rank of General.[i] He posted to Jamaica, Mauritius, St. Helena Island, Trinidad, Malta, Corfu, and the Crimea where he improved hospitals, community health, and individual wellness. He is credited with performing one of the first successful cesarean sections in 1826. Prior to that, the operation delivered living babies from dead mothers, dead babies from living mothers, or dead babies from dead mothers.[ii] The infant was named James Barry Munnik as was his son and grandson.
Dr. Barry’s last appointment was to Canada where he advocated for better accommodations for army men and their wives. After having spent close to 40 years in the tropics, James battled winter colds and bronchitis, illnesses that eventually drove him back to London. He died from diarrheal disease during an epidemic of dysentery there. Ironically, it was caused by poor sanitation.
James’ directives for his death included the strange admonition to bury him in the clothes he was wearing, without bodily inspection or autopsy, as soon after his last breath as possible. The instructions were ignored. After 56 years of acting as a man, the secret of James Barry’s physical sex was uncovered by Sophia Bishop, the housemaid who prepared him for burial. The body was undeniably female; in addition to breasts and female genitalia, she had on her abdomen the stretch marks of pregnancy! Sophia sold her discovery to the press and the secret was out. The mortified military sealed Dr. Barry’s records for 100 years.
There is no question that Dr. Barry was a good doctor and surgeon, both in his diagnostic and manual skills and in his concern for his patients. What remains in question is his personal disposition about becoming, for all intents and purposes, a male. Three main possibilities have been offered:
- Perhaps Margaret was a woman who continued to pretend to be a man until her death so that she could continue to do a job she liked and was good at, one that gave her independence and income that was withheld from women at that time.
- Perhaps James was a transgender man who was very comfortable with his new gender and who had worked hard to achieve his ability to live his life as a man.
- Perhaps Margaret/James was intersex when society had no word for it, his interest in medicine piqued by curiosity about his own biology, and who was most comfortable when taking care of the biologies of others.
There is no smoking gun that will give us a definitive answer. But we know that Dr. Barry was exceptional. He lived his life as a man. And he wanted to be remembered as a man after he died. His work in improving the lives of the sick, the health of communities, the lives of the downtrodden, unlucky, discriminated against, enslaved; in opposition to racism and discrimination and slavery. He promoted public health before public health was a science.
One has to wonder, were he not born a female, would his life be more celebrated? Let’s now celebrate Dr. James Barry for his successful 56-year subterfuge and for breaking the bonds of patriarchy that would not allow women to practice medicine. He proved that women were able to learn anatomy and physiology, biology and chemistry, pharmacology and surgery. He showed that women were not too weak to perform an amputation or too tender to perform an autopsy, popular excuses at the time. And he showed a man can be gentle and caring with his patients as well as he can demand changes to better the lives of soldiers, slaves, and regular people. We could use a few more physician/surgeons like the good Dr. James Barry.
For more information on the fascinating life of Dr. James Barry, I recommend the books, Dr. James Barry: A Woman Ahead of her Time by Michael du Preez and Jeremy Dronfield and Scanty Particulars: The Scandalous Life and Astonishing Secret of Queen Victoria’s most Eminent Military Doctor by Rachel Holmes.
 du Preez M, Dronfield J. 2016. Dr James Barry: A Woman Ahead of Her Time. OneWorld Publications. London.
 Holmes, R. 2002. Scanty Particulars: The Scandalous Life and Astonishing Secret of Queen Victoria’s Most Eminent Military Doctor. Viking Press. London.
[i] Tishma M. A surgeon and a gentleman: the life of James Barry. Hektoen International 2020;12(3). Available at https://hekint.org/2020/04/03/a-surgeon-and-a-gentleman-the-life-of-james-barry/. Accessed 12Dec2021.
[ii] O’Sullivan JF. Caesarean birth. The Ulster medical journal 1990;59(1)1-10. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2448256/?page=1. Accessed 12Dec2021.