The UK Space Agency has announced an agreement with Vast – a US commercial space company – that could send British astronaut John McFall into orbit as early as 2027. If the mission goes ahead, he would become the first person with a physical disability to live and work in space.

McFall, who lost his right leg above the knee in a motorcycle accident at 19 and uses a prosthesis, is a former Paralympic sprinter, a practising NHS surgeon and a qualified European Space Agency (ESA) reserve astronaut.

ESA selected him in 2022, and in 2025 he became the first person with such a disability to be medically certified for a long-duration mission.

The media have largely framed this as a story about inclusion, but there is more to the story than that. For a physiologist, it raises a different question: what happens to a body that already moves, balances and functions differently under gravity if you remove gravity altogether?

The honest answer is that we don’t yet know, and that uncertainty is the point. In one important respect, we are exploring space for the first time. Almost everything we know about how the human body responds to spaceflight comes from studying people without physical disabilities.

In the........

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