James Barry has been described as "one of the most romantic figures in the annals of medical history as well as an enduring enigma to all would-be biographers. The circumstances of his life have been dramatised to such a degree and so much speculation woven around the meagre facts that do exist, than an objective approach to it has become well-nigh impossible" (Burrows, 1958, p. 80). Barry was born about 1795, and his father appears to have been a brother of the artist James Barry (1741-1806). He moved to Edinburgh in 1809 and qualified as Doctor of Medicine there in 1812 (i.e., aged about 18), dedicating his thesis to his two influential patrons, General Francisco de Miranda and the eleventh earl of Buchan. He qualified as a regimental surgeon in January 1813 and served as hospital assistant in Plymouth and London to December 1815, when he was promoted to assistant surgeon. He was sent to the Cape Colony, arriving in August 1816, where in addition to his official duties he acted as private physician to governor Charles Somerset and his family.
In March 1822 Barry succeeded Dr J. Robb as colonial medical inspector, and in the same year Somerset made him principal medical officer of the militia at the Cape. His medical competence was highly rated and there is no doubt about his ability as a medical practitioner. However, he had antagonised many by preventing unqualified persons from practising medicine, forbidding the sale of drugs by merchants, and repeatedly criticising the conditions and treatment of inmates of the leper institution near Caledon, Somerset Hospital, and the jail in Cape Town. His numerous letters to the Colonial Office in Britain also showed little respect for official dignity. Following a dispute with the fiscal in 1825 he lost his post as colonial medical inspector, but this did not affect his military career, for in November 1827 he was promoted to staff-surgeon. Although a sale of his carriage, horses, and part of his furniture was advertised in the South African Commercial Advertiser of 23 November 1825, he left the Cape only in October 1828, having been posted to Mauritius.
Barry made medical history when, on 25 July 1826, he delivered Mrs. Wilhelmina J. Munnik of a son by performing what appears to have been the first completely successful caesarean section in the English speaking world, in that both mother and child survived. The boy was named James Barry Munnik in his honour.
The social reforms instituted by Barry at the Cape also constitute an important contribution to medicine. His inspection of public institutions led to improvements in diet, hygiene, and treatment, and shows that he had a good conscience and a determination to obtain justice for the unfortunate inmates. After leaving the Cape Barry served in Mauritius and in the West Indies. He was promoted to deputy inspector-general of hospitals in 1851 and stationed on the island of Corfu. In 1858 he became inspector-general of hospitals in Canada, but ill health led to his retirement to England in 1859.
Despite Barry's undoubted competence as a surgeon and his success as a social reformer interest in him has often focussed on a controversy regarding his gender. He was a small person with a high-pitched voice and an effeminate manner, so that even during his lifetime there was some speculation that he might be female. Upon his death in 1865 the charwoman who laid out his body stated that he had been a woman. No other direct evidence is available. He may well have been a male pseudohermaphrodite, in which the external sex organs and bodily appearance are predominantly female, while the gonads are those of a male. In accordance with his social role he is classified as a male in this database.