The book of Job goes into great depths on this subject! Job's friends try to tell him that his suffering must be caused by some sort of sin, and God explains at length that they are wrong - theologically, there is no direct link between a person's actions and illness / suffering.

As others have mentioned, this changed with the Corbett v Corbett case in 1970, when judge Roger Ormrod ruled that a "change of sex" can only have legal meaning if basic observational mistakes were made at birth.

The first known amendments to the sex column on grounds of gender identity in adulthood date to 1944 (Michael Dillon and Robert Allen), but there's likely quite a few that we just don't know about in the files of the General Register Office.

However, there was still a great deal of flexibility for most of the following century and a half. Section 36 of the Births and Deaths Registration Act 1874 allows for changes of "fact or substance" upon production of statutory declarations from parents and a doctor.

Birth registration was made up of a patchwork of local and church records before 1837. The Births and Deaths Registration Act of that year created the modern central register. The fourth column on these standardised birth certificates records sex ("girl" or "boy").

Clock's ticking on the "Trans Mob forced me to quit the BBC" timer

Creating new problems in the process of trying to solve old ones was a bit of a trend throughout Cowell's life. I don't think she lied about her medical history nearly as much as is usually implied (a subject for another time), but some of her claims answered one question and raised 10 others.

It's proving extremely interesting though - the Aspin engine tried to solve many longstanding problems in conventional engines, and it kinda did, but it created so many new problems that by the time you found solutions, most of the benefits were no longer there.

The main thing we have to do to properly understand who she was is therefore to reverse that trend, so a trans biography is paradoxically going to give her transness a much lower billing than the norm. We have to take the obsessiveness out and put the context back in.