A debate about the gender identity of Dr James Barry, the pioneering Victorian who adopted a male persona to become the UK’s first female-born doctor, has erupted after the award-winning author EJ Levy was accused of disrespecting Barry’s legacy by using female pronouns in a forthcoming novel.

Levy announced last week that she had sold a novel about the “true story” of Barry, titled The Cape Doctor. The forthcoming book, which will be released by Little, Brown, will trace Barry’s life story: born Margaret Ann Bulkley in Ireland, the future doctor became Barry at the age of 20 and left for Edinburgh to study medicine as a man. Barry joined the army after graduation, the start of a distinguished career as a military surgeon that spanned Cape Town, St Helena and Trinidad and Tobago. In 1865, Barry returned to the UK with dysentery, and died. A maid discovered the doctor’s biological gender after the death.

When Levy, winner of the Flannery O’Connor award, announced the news of her novel by describing Barry as “a heroine for our time, for all time”, other authors began to question Levy’s reference to Barry as “she”, including novelist Celeste Ng, who told Levy: “I’m now seeing you use she/her pronouns for Barry even as many are telling you Barry himself used and wanted he/him pronouns. I hope you and L,B will listen to these concerns and take them into account.”

Transgender performance poet Jay Hulme called Levy’s position “abhorrent”, while writer Alexandra Erin tweeted: “He categorised himself as a man, lived as a man, died as a man, and would have preferred to be buried as a man. There’s no room for interpretation.”

Levy, who identifies as queer, defended her use of female pronouns in the novel. “In death, as in life, Dr Barry engenders controversy, but one thing is clear: she refused facile gender categories. So do I, in my novel,” she wrote on Twitter. “I work from historical facts, as do Barry’s biographers, who identify her as she … I’ve read and researched for years. To insist Barry is trans distorts complex history … There’s no evidence Barry considered herself trans; she dressed as [a] man as needed to be [a] soldier, doctor … Shifting readings of her body are what my novel wrestles with; it’s been taken into account; I use she/her as her biographers do.”

There’s evidence that Barry missed being a woman. But we also know that he relished being a man Jeremy Dronfield

Barry’s gender identity has been overwhelmingly framed as female by writers over the past 150 years, said Cardiff University professor Ann Heilmann, author of Neo-/Victorian Biographilia and James Miranda Barry: A Study in Transgender and Transgenre, exceptions being Patricia Duncker’s 1999 novel James Miranda Barry and Rachel Holmes’s 2002 biography The Secret Life of Dr James Barry.

Heilmann said she believed Barry “felt” male, adding: “But whether he had always ‘felt male’ during his earlier female years (he changed identity at age 20), who knows? … Much of what we ‘know’ about him is really the Barry myth – that is, culturally constructed legend, based on hearsay, fiction and fiction-inflected biography.”

The Cardiff academic said that while it was possible that Barry’s initial decision to assume a male identity was driven by a wish for an independent life and career in medicine, her impression was that “he then ‘became’ male in terms of his inner (and not only outer) … identity. That would still make him trans in today’s terms, and I approached the real-life character as a trans person”.

“While I understand that emotions run very high (understandably so, given the difficulties trans people face and in light of ongoing tensions between feminism and the trans community), I don’t think that Barry can be that easily mapped on to contemporary trans thought,” she said. “Though of course there have always been trans people, the lived and felt gender identity of an 18th and early 19th-century person would have been very different from our contemporary identity politics.”

Holmes said that using female pronouns for Barry was “really quite disrespectful”.

“As a young feminist when I set out to write this book, which was based on PhD research, I thought I was writing a story of a woman who cross-dressed in search of fame and fortune because she couldn’t become a doctor wearing skirts. I was struck very quickly when I started doing research that this wasn’t the case at all,” she said.

Holmes’s biography identifies Barry as having androgen insensitivity syndrome, which the NHS defines as describing a child who is genetically male, but whose genitals appear female or somewhere between male and female.

“It is perfectly clear that Barry had ASS and effectively would now be a trans person. He didn’t have the language or the science, but he was looking for it,” Holmes said. “This is someone who fought his whole life for that identity, and understood himself to be betwixt and between.”

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Jeremy Dronfield, co-author of Dr James Barry: A Woman Ahead of Her Time, said: “In my biography, I used male pronouns for Barry. He was, at least outwardly, a man. But whether Barry qualifies as transgender in modern terms is complicated. When Margaret became James, it wasn’t primarily because she wanted to be a man. She wanted to live the kind of life which in 1809 was impossible for a woman. Once the persona had served its purpose, Margaret intended to discard it. Circumstances prevented that. There’s evidence that Barry missed being a woman. But we also know that he relished being a man, his behaviour exceeding what was necessary for disguise. However, the claim made online that Barry left a will asking to be remembered as a man is false. He left no statement of identity.

“If Margaret had been born in 1989 instead of 1789, free to be a surgeon and soldier, would she have chosen to become a man? On balance, I don’t think so, but Margaret might have identified as non-binary. I have no argument with seeing James Barry as a transgender icon, or Margaret as a feminist role model. I do take issue with those who insist on recognising one and erasing the other.”