But there are some things that are known about her early life. She's believed to have been the niece of the 18th century painter, James Barry. Her mother (his sister) had fallen on hard times, and found refuge of a sort with her brother in London, or perhaps with one of his many bohemian and free-thinking friends. Among those friends were Lord Buchan who espoused the rights of women, and General Francisco de Miranda, the Latin American revolutionary-in-exile who was known to have an extraordinary medical library. At least one biographer has speculated that it was under the influence of these two men, that the young and gifted girl was enrolled at Edinburgh as a medical student, disguised as a boy and under the name James Miranda Barry. After medical school, she joined the Army medical corps. She was thirteen. Many commented on her unusual appearance and she seemed to do her best to exaggerate her masculinity as a result. She was known as a loner and an eccentric, and something of a crank, but her medical skills were widely appreciated, and she made the usual career advancements. She died in London, age 65, having been forced into retirement. It was the woman who took care of her body after her death who revealed her secret.

Of course, the revelation was a bit of an embarassment for her personal physician, who attempted to cover himself by proclaiming that for all he knew Dr. Barry might have been an "imperfectly developed man." It's this statement that Rachel Holmes uses to launch her argument that Barry was, in fact, a hermaphrodite. It's even less convincing than her estimate of the doctor's age and identity.

Her most vigorous argument in favor of hermaphrodism is the choice of dissertation by the young medical student - female hernias. Before imaging techniques were widely available, undescended testicles were often mistaken for hernias, and in women they were sometimes the means by which hermaphrodism was discovered. Holmes speculates that James Barry chose that topic because she had a hernia herself, and therefore an undescended testicle, despite no evidence of any such ailment. The author mentions references by Barry to "cushions" that she needed to use for personal reasons. Most authors have understood those to be sanitary pads. Holmes understands them to have been trusses for the care of a hernia. Sanitary pads seem more likely. And as for the choice of a dissertation, it isn't unusual for a young woman to choose a subject that would allow her to learn as much as possible about the female anatomy.

There are other problems with the hermaphrodite theory. The woman who prepared Barry's body for burial also noted that she had stretch marks, as if she had once had a child. This is dismissed by Holmes as a misinterpretation of the ravages of yellow fever and other tropical diseases. But those diseases don't leave stretch marks like those of pregnancy. And there are some details in Dr. Barry's life that suggest that she was once in love and perhaps had a child.