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Pioneer, trailblazer, history-maker. Or in her own words “a semi-retired octogenarian ophthalmologist trying to work on my golf swing”.

The life of Dr Renee Richards - born Richard Raskind - has been, by any standards, extraordinary. Now 84, she can reflect on three separate careers: as a leading eye surgeon, as a human rights campaigner and as the first transgender woman to play professional sport.

These days Richards lives a quiet life in Putnam County, an hour north of New York City, still seeing patients three days a week and playing golf regularly. She rarely gives interviews, but spoke to Telegraph Sport to discuss transphobia, the idea of a level playing field in sport, and her landmark case in 1977 that saw Richards permitted to compete at the US Open as a woman, two years after undergoing gender reassignment surgery.

More than four decades on, the debates around the transgender community are as fiercely contested as ever - especially in sport where issues of tolerance rub up against notions of fair play. Few are as well placed to comment as Richards who - perhaps surprisingly - is in agreement with Martina Navratilova, a player she once coached, that transgender athletes who have not had a sex-change operation have an unfair advantage.

“The notion that one can take hormones and be considered a woman without sex reassignment surgery is nuts in my opinion,” Richards says. She also revealed that she would never have competed as a woman if she had transitioned in her 20s rather than 40s because she "would have beaten the women to a pulp".

This is another important distinction for Richards. Even those who have had full gender reassignment surgery would, in her view, be at a major advantage if they did so when at the peak of their physical powers

The issues around transgender athletes are hugely complex, but to understand Richards' perspective, it is necessary to understand her remarkable story - one that has been the subject of two autobiographies and two movies, one starring Vanessa Redgrave.

Richards fought to compete at the 1977 US Open as a woman credit: getty images

Born male in 1934, Raskind was the son of a surgeon and a psychiatrist, prominent members of New York’s Jewish intellectual elite. Raskind had the outward trappings of contentment - a Yale degree, a career as a promising eye doctor, married to a model and with a son, Nick. Then there was a useful sideline in tennis, where a left-handed serve from a spindly 6ft 2in frame earned captaincy of the Yale team, a win in the All Navy Championships and a New York State title, plus qualification for the US Open five times.

Yet the reality was that Raskind was locked in tumult over gender and identity. After years of taking hormones, gender reassignment surgery in 1975, aged 40, meant Richard became Renee. The name means ‘reborn’ in French, a point not lost on Richards.

The operation was a far more drastic step than it would be now. Attitudes were largely unforgiving in mainstream society, and the trans community were often forced to flee where they lived and start a new life elsewhere. “It wasn’t an open subject,” Richards explains. “It was a very quiet secret if somebody wanted to have a sex change. You did it quietly and started a new life - frequently in a new city with a new name, and total change of identity.”

Richards moved to California hoping for anonymity, but she was outed as trans while playing a tournament there in 1976 and told she would not be welcome at the US Open. The tournament went as far as instituting a chromosome test to prevent Richards from playing.

At this point Richards’ stubbornness kicked in. As much as this was a human rights issue, Richards admits it was also about the fact that “I don’t like to be told I can’t do something”. She sued the United States Tennis Association, and with affidavits from her surgeon and Billie Jean King confirming that she was psychologically, physically and physiologically a woman, Judge Alfred Ascione ruled in her favour.

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Richards, by now 43, was permitted to enter the 1977 US Open, and reached the doubles final after losing in the first round of the singles to Virginia Wade, fresh from her win at Wimbledon.

Acceptance from her peers took considerably longer, however. “The first year was very hard," she says. "There was a lot of ostracisation, apprehension and coldness. Some players refused to play me. Kerry Reid [the Australian former world No 7] walked off the court the first time she played me.”

But by the time Richards retired four years later, having achieved a world ranking of 20, she was broadly accepted by the players on the Women's Tennis Association (WTA) tour, once they realised that she was not going to sweep all before her. Richards then returned to New York to continue her career as an ophthalmologist and coached Navratilova to multiple grand-slam titles.

It is in part thanks to Navratilova that more than 40 years since her landmark case, Richards' story remains as relevant as ever. Navratilova recently electrified the debate around transgender athletes by saying that those who have not had gender reassignment surgery are at a huge advantage. Dismissing the requirement to take medication that reduces testosterone levels to a level equivalent to a woman, Navratilova described transgender athletes competing as women as "insane and cheating". Her main argument was that the residual benefits of being a man since childhood, such as increased muscle mass, would give transgender women an unfair advantage.

The success of the cyclist Dr Rachel McKinnon, who in October won sprint gold at the Masters Track Cycling World Championship in the 35-44 age category, was branded "not fair" by one of her rivals Jennifer Wagner-Assali. McKinnon has vociferously defended her right to compete and last year pointed to a study that suggested there was no relationship between an athlete’s testosterone levels and performance. Other research refutes this.

Richards believes the relatively late age at which she transitioned was crucial in ensuring she did not have a physical advantage over her rivals credit: getty images

As it stands, organisations like the WTA and International Olympic Committee are satisfied that transgender athletes can compete as long as they have been living for a minimum of 12 months with no more than 10 nanomoles per litre of testosterone.

Rather than being offended by her former charge's comments, Richards - who was contacted by Navratilova as part of her research into these issues - is passionately in agreement, arguing that the only thing that stopped her dominating the women's tour was her age, which counteracted her genetic advantages.

Her different perspective also stems from the fact that despite being trans herself, Richards, 84, has a contrasting profile to the most vocal members of the community - many of whom are young and liberal. "I’m very much binary," she says. "I like the difference between men and women. I like the concept of male and female - it’s the spice of life, it’s what makes life continue. I don’t like the grey area, the fluidity. It’s not appealing to me. I would not be condemning of somebody who wants to live like that but that wouldn’t be me."

Where Richards is uncompromising is that those who are gender fluid or non-binary and have not had gender reassignment surgery should not be allowed to compete as women in sport.

"If someone isn’t a true transgender transsexual and doesn’t live their life as a woman then it is unfair for them to compete," she says. "I know various certifying boards in their infinite wisdom are saying that surgery is unnecessary and that only hormonal treatment is, but I’m not sure that’s appropriate because a big part of a person's sexual identity is their sexual parts.

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"I think it being compulsory to have had the operation would certainly be a part of it. I don’t think your identity is quite bona fide or certified unless you have had the surgery.

"Also, if someone had surgery when they were 20, then you wouldn’t have a level playing field. Because that person would be much too strong and advantaged against women. When the judge in my case found in my favour, he was very careful not to make a blanket statement about transgender people. And he was a very wise man in doing that. If he hadn't he would have opened the door for a 20-year-old cyclist or soccer player or whatever."

There has hardly been a stampede of transgender athletes following in Richards' wake - McKinnon and golf’s Mianne Bagger are two of a mere handful. That number may well increase, but Richards believes that it will be very difficult for trans athletes to gain acceptance now if they have stopped short of gender reassignment surgery or if they have done so at a stage of their career when they can dominate the field.

"I would have been mortified if I had won grand slams as a woman, and I would have stopped on the spot," she says. "I would never have pursued something that would have given me an unfair advantage. But I wasn’t any more successful than I had been when I had been competing in 35-and-over tournaments as a man before I had the sex change.

"I was a finalist in the US Open 35-or-over, just as I was in the final of the women’s 35-and-over many years later. I was a good player and entitled to win matches, but if I had overwhelmed the field of course not. It would have been crazy."

The length of time it takes for residual advantages to recede is difficult to quantify. A further complication arises with intersex athletes such as Caster Semenya, who has high testosterone levels due to being born with internal testes. The Court of Arbitration for Sport will imminently deliver its verdict on whether Semenya will have to suppress her testosterone levels to comply with limits set by the International Association of Athletics Federations (IAAF). Richards vehemently believes that Semenya, as a woman, should not be forced to reduce the testosterone levels she was born with and must be allowed to compete.

Richards does not believe South African runner Caster Semenya should be forced to reduce the testosterone levels credit: PA

Generally though, Richards prefers to stay out of the debate. Living with her long-time assistant Arleen Larzelere, 72, Richards' focus now is on seeing patients - she only stopped performing surgery three years ago - and her golf game. Still playing off a handicap of 17-18, Richards plays almost every day for six months of the year in her local club's ladies league.

Socially, Richards is on friendly terms with her one-time tennis rivals, communicating regularly on a dedicated Facebook group for WTA alumni. Much of the group's conversation is about modern-day tennis, with Richards still an avid watcher, and particularly keen on Novak Djokovic, Naomi Osaka and emerging stars like Stefanos Tsitsipas. She also remains close with her son Nick, now a 47-year-old real estate developer in Miami.

If life has become more ordinary in recent years, her achievements both in and outside sport, will stand the test of time. "My biggest achievements are as an eye surgeon - I’ve operated on more than 20,000 children’s eyes," she insists. "But my legacy is probably going to be more my career in human rights. I never really did much actively. I just did something that served as an example.

"I wasn’t an advocate, or someone on the stump agitating. I’ve never been like that but because of how my life turned out I am a pioneer for the whole transgender and transsexual movement, and with its elaboration to other disenfranchised people too."

And would she change anything from the last 84 years? She laughs heartily. "I’ve had a pretty good life. A little hectic at times! But regrets? No."