With the unfolding of the horrific abortion ban in Texas, there has been immense discussion around reproductive rights and bodily autonomy. Two notable themes have emerged for me — both the paternal sense of ownership that leads to the desire to control female bodies, and the insistence that those female bodies can only ever belong to women.
Trans people have always been here. Transmasculine and nonbinary people must be included in discussions of reproductive health, both because our lived experiences are valuable and because systematic medical exclusion of these groups is deadly, particularly when it comes to reproductive healthcare.
This is not a new thought, nor a new practice. To show you what I mean, I want to tell you a story. As with all of these articles, I will not misgender the dead, even if many sources about them often do.
Dr. James Barry was born a girl to a poor grocer in County Cork, Ireland in around 1790. At the time of his death in 1865, he would be an internationally recognized medical innovator, public health advocate, and forerunner in the emerging field of sanitation science.
Barry had always shown an aptitude for learning, but with limited funds (and an older brother who the family pinned their future hopes on), education was out of reach for much of his childhood. When his brother vanished and his father was sent to debtor's prison, Barry and his mother were in dire straights until Barry's uncle, also known as James Barry, died. The elder James Barry had been a painter and professor at the Royal Academy of Arts in London, and the younger James Barry inherited not only his money, but his contacts.
Barry took up tutoring work to support himself and his mother, some of the only work available to a young woman at the time. Crucially, he tutored the son of General Francisco Miranda, a Venezuelan revolutionary. It's likely that Miranda helped to form the plan - that Barry would enroll in medical school as a man, graduate, and then move with Miranda to Venezuela to practice medicine, freed from the burden of having to "pretend" to be a man. In 1809, Barry enrolled in medical school, choosing to pursue additional education in both military surgery and midwifery. His graduation in 1812 was almost derailed when the University insisted he was too young to graduate (pretending to be a teenager explained his lack of facial hair), but another of the late James Barry's contacts stepped in and advocated for the younger Barry, securing his graduation.
The plan to go to Venezuela fell apart as General Miranda was betrayed and imprisoned until his death in 1816. The newly minted Dr. Barry abandoned the initial plan to go back to living as a woman, and instead enrolled as a student at Guy's and St. Thomas' Hospital before applying to the British Military in 1813. Due to being a doctor, his word as to his own physical health was taken, and he was able to forego the physical exam. In 1816, he was sent to South Africa to be the personal physician to Lord Charles Somerset, the governor of the Cape. He was quickly promoted to the Colonial Medical Inspector in 1822, amidst rumors of an affair between the Lord and his physician.
As the Colonial Medical Inspector of the Cape, Barry was fierce and unyielding in his reforms, which ranged from requiring medical professionals to be licensed to reconstructing drinking water infrastructure to improving living conditions for prisoners, those in asylums and those with leprosy. As ever, he was irritable and insistent in matters of politics.
In 1826, as Colonial Inspector, Dr. Barry became one of the first European surgeons to successfully perform a caesarian section in which both the mother and infant survived. It was regarded as nothing short of a medical miracle. This news made him even more famous than he already had been, both for his skill as a physician and administrator and his quirks as an individual. He was often angry, even to the point of throwing things or getting in frequent arguments, even with superior officers. He brought an assortment of small animals with him as he traveled. He was a vegetarian and a teetotaler, famously sensitive about his height and fussed about his dress, and intensely private, with few friends. He was considered a catch, but never married and lived with a single servant, named John, for much of his life. He refused to compromise care with any patient, rich or poor, colonist or slave, prisoners or asylum patients. In a highly stratified society, he argued for and implemented health interventions for the poorest and most destitute.
His feat with the caesarian section got him a promotion still further, to Army Medical Inspector, a position that allowed him immense authority in the British military at large. This position required he travel often, and much of his work involved reform, particularly sanitation reforms and reforms for the living conditions of the downtrodden of society. In 1857 he was posted to Canada, where he was interrupted in 1859 from his work advocating for better nutrition and housing conditions for low-ranking soldiers by respiratory illness.
He was discharged and sent back to London. Although once he recovered he fought fiercely to return to service, he was never reinstated, and eventually died of dysentery in 1865.
His burial instructions were quite clear—he wished to be buried in the clothes he died in, without being examined and as quickly as possible. He wanted to be remembered as a man, as Dr. James Barry.
A scandal in Victorian society ensued when his burial instructions were ignored, and a woman named Sophia Bishop washed and examined his body in preparation for burial, telling others that Dr. Barry was a "perfect female". Even more shocking, he had stretch marks on his abdomen, indicating that he had once been pregnant.
The news was a revelation and a scandal. The famous Dr. Barry, who was a duelist and had held one of the most prestigious positions in the British Army, had been "revealed" as a "woman".
Many acquaintances, who had never uttered a word during his life, came forward to say they had always suspected Dr. Barry.
The scandal flourished, then subsided, and the incredible life and contributions of Dr. James Barry were swept aside in embarrassment.
So, one hundred and fifty years later, I tell his story. Why does it matter to us?
It matters because bodily autonomy is still being violated. And it matters because trans men are still being systemically left out of the conversation.
Content warning for discussion of rape and pregnancy.
Upon his death, besides the fact that Dr. Barry was female, it was also revealed that he had stretch marks, indicating that he had likely been pregnant at some point in his life. Sleuthing in the modern era has established that he likely fell pregnant as a teenager who had been raped by a family member. It's perhaps this experience that led Dr. Barry to so doggedly advocate for the rights and treatment of pregnant people, which led him to be one of the first Western surgeons to successfully perform a caesarian section, which led him to be a doctor of great renown and influence.
Whatever his motivations, trans men have been involved, as parents for time immemorial, and as physicians for hundreds of years, in the issue of pregnancy. Discomfort is not an excuse to avoid the discussion of a necessary and vulnerable population to these issues.
Transmasculine erasure, both in history and in the present, has deadly consequences for transmasculine people. Perhaps one of the starkest examples of this is when this entire population is left out of conversations about reproductive care and access.
Reproductive care has come a long way from the days when a caesarian section where the mother lived was a medical marvel. Let's allow transgender inclusion in that care to progress just as far.
For further reading: