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, a human rights campaigner and the first transgender woman to play professional sport.

These days, Richards lives a quiet life in Putnam County, an hour north of New York, still seeing patients three days a week and playing golf regularly.

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She rarely gives interviews, but spoke to the UK Daily Telegraph 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 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 she would never have competed as a woman had she 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, have a major advantage if they did so when at the peak of their physical powers.

The issues around transgender athletes are 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 films, one starring Vanessa Redgrave.

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.

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Then there was a useful sideline in tennis, where a left-handed serve from a spindly 1.8m frame earned the 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, at age 40, meant Richard became Renee. The name means "reborn" in French.

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.

Renee Richards hits a return during the Women's 1977 US Open Tennis Championships circa 1977. Photo / Getty Images
Renee Richards hits a return during the Women's 1977 US Open Tennis Championships circa 1977. Photo / Getty Images

"It wasn't an open subject," Richards says. "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, the court ruled in her favour.

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.

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 No7] 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 tour, once they realised she was not going to sweep all before her. Richards 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 those who have not had gender reassignment surgery had a huge advantage.

Dismissing the requirement to take medication that reduces testosterone 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.

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

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.

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 stopped performing surgery only three years ago — and her golf game.

If life has become more ordinary in recent years, her achievements both in and outside sport will stand the test of time.