Suydam was first examined, before the election, by Dr William Barry. Barry's examination found that Suydam had an imperforate penis, a scrotum and a testicle on one side. On this basis, he declared Suydam male.

However, a second doctor, who supported the opposing party objected. Dr Ticknor examined Suydam on election day. His findings corroborated Dr Barry's - he, too, agreed that Suydam was male.

As he had been declared male, Suydam was permitted to vote. His party, the Whigs, won the election by one vote.

But a few days later, Barry changed his mind. He had heard that Suydam menstruated.

The account that Suydam had periods was confirmed by his sister, who said that she cleaned his menstrual cloths, and that he regularly menstruated, "but not as profusely as most women". This led to further scrutiny of Suydam.

A second examination by Barry and Ticknor found that Suydam had a vaginal opening. Barry also records that Suydam's body was "feminine". However, that wasn't exactly what caused the doctors to declare him female...

The legal status of intersex people at the time depended on which sex "prevailed". Suydam's body had characteristics fitting male and female, so the physicians turned to social aspects of his life.

Barry's case report discusses several characteristics which in his opinion made Suydam female. First among these was that Suydam was attracted to men.

As well as this, Barry cites that Suydam had "a fondness for gay colours", that he enjoyed placing coloured swatches of calico together, and that he had "an aversion for bodily labour".

It was these "feminine propensities" which led Barry to revise his opinion.