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On the 2nd of July 1813, a young man successfully passed his examination of the Royal College of Surgeons of England, earning his doctoral degree qualifying him as a medical surgeon.

His medical education had not been without obstacles. In fact, he was very nearly denied entry into medical school at all - not because of his grades or intelligence, but because his short stature, unbroken voice, delicate features and smooth skin led many to suspect that Barry was a young boy not past puberty. The University Senate at Edinbourgh initially attempted to block Barry's application for the final examinations due to this apparent youth. However, David Erskine, the 11th Earl of Buchan, and a close family friend, personally persuaded the Senate to relent. What neither the Senate nor Lord Buchan knew at the time was that young James Barry's stature and voice were not due to his youth, but to his status as a trans man.

So, in 1812, at the age of 23, a young James Barry earned, first his medical degree, and then not a year later, his license to practice as a surgeon. Barry immediately enlisted in the British Army and was enlisted as a Hospital Assistant, taking posts in Chelsea and then Plymouth. Not two years later, in December of 1815, he was promoted to Assistant Surgeon to the Forces (a rank equivalent to lieutenant).

Once again, Lord Buchan came to the young man's aid. His next posting was to Cape Town, South Africa - which had been permanently ceded to the United Kingdom from the Dutch a year prior as part of the treaty following the Napoleonic Wars. Through Lord Buchan, Barry had a letter of introduction to the Governor of Cape Town, a Lieutenant General Lord Charles Somerset.

Charles' daughter had been gravely ill for some time, and Barry was able to nurse the young girl back to full health in what some called a miraculous recovery. Charles then welcomed Barry into the family with open arms. James became his personal physician and the two maintained a close personal friendship for years.

In 1822, at the age of 33, Somerset appointed Barry as Colonial Medical Inspector. This was an extraordinary career jump from Barry's previously low military rank, bringing with it a lot of new responsibility which James was determined not to squander. Over the next ten years of work in the Cape, James was able to effect significant changes such as improved sanitation and water conditions, better conditions for enslaved people, prisoners and the mentally ill, and the creation of a sanctuary for a local leper population.

But his crowning achievement in the field of medicine was performing the first ever known C-Section birth in which both the mother and child survived. The child was named James Barry Munnik in Barry's honor, and the name was passed down through the family for generations. One of that child's later descendants, still bearing the same name, became Prime Minister of South Africa. General James Barry Munnik Hertzog, better known as Barry Hertzog or J. B. M. Hertzog, was one of the principle advocates during the late 1920's and early 1930's for the development of Afrikaner culture and was determined to prevent Afrikaners from being excessively influenced by British culture.

Barry was promoted again to the rank of Surgeon to the Forces on the 22nd of November, 1827, and subsequently posted to Mauritius. A year into his assignment, Lord Somerset took ill, and Barry went AWOL, risking his entire military career, to go care for his sick friend in England. He stayed there until Charles' death in 1831.

James then took a series of postings, to Jamaica, the island of St Helena, the West Indies, Malta, Corfu, and Canada. He dealt with outbreaks of yellow fever, and a cholera epidemic which eventually claimed the lives of over a million people worldwide. Barry rose through the ranks, earning promotion after promotion, relentlessly fighting for better food, sanitation and proper medical care for prisoners and lepers, as well as soldiers and their families wherever he went.

Barry was outraged by unnecessary suffering, and took a heavy-handed and sometimes tactless approach to demanding improvements for the poor and underprivileged which often incited anger from officials and military officers. On several occasions Barry was both arrested and (temporarily) demoted for the extremity of his behavior.

In 1859, over his very vocal protests, Inspector General James Barry was forcefully retired from the military, citing his now advanced age and ill health. James retired to London, and died six years later of dysentery.

The charwoman who laid out his body discovered James' assigned sex at birth and attempted to blackmail Barry's physician, a Major D.R. McKinnon, who had issued the death certificate, threatening to go public with the knowledge if she was not paid. When McKinnon refused, she followed through with her threat. As the situation became more and more public knowledge, George Graham of the General Register Office asked McKinnon about the story's veracity. McKinnon responded in writing. Among his many remarks about having known James for many years, he said this: "[The charwoman] seemed to me to think that she had become acquainted with a great secret & wished to be paid for keeping it, I informed her that all Dr Barry's relatives were dead, & that it was no secret of mine, & that my own impression was that Dr Barry was a Hermaphrodite. But whether Dr Barry was male, female, or hermaphrodite I do not know, nor had I any purpose in making the discovery as I could positively swear to the identity of the body as being that of a person whom I had been acquainted with for a period of eight or nine years."

Barry is buried in Kensal Green Cemetery, with a Portland stone headstone, on which is inscribed simply "Dr James Barry, Inspector General of Hospitals"

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