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Former Taiwanese President Lee Teng-hui waves to the crowd outside the presidential palace, in Taipei, in an undated file photo.

Simon Kwong/Reuters

Former Taiwanese president Lee Teng-hui, who brought direct elections and other democratic changes to the self-governed island despite missile launches and other fierce sabre-rattling by China, has died. He was 97.

Taipei Veterans General Hospital said Mr. Lee died Thursday evening after suffering from infections, cardiac problems and organ failure since being hospitalized in February.

Mr. Lee strove to create a separate, non-Chinese identity for Taiwan, angering not only China, which considers the island part of its territory, but also members of his Nationalist Party who hoped to return victorious to the mainland.

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Mr. Lee later openly endorsed formal independence for the island but illness in his later years prompted him to largely withdraw from public life.

“President Lee’s contribution to Taiwan’s democratic journey was irreplaceable and his death is a great loss for the country,” current President Tsai Ing-wen said in a statement.

Ms. Tsai’s predecessor, Ma Ying-jeou of the Nationalists, who earlier served in Mr. Lee’s cabinet, said Mr. Lee’s contribution to Taiwan’s democratization “deserves recognition from the people.”

“Although former President Lee’s political philosophy has undergone tremendous changes after his resignation, former President Ma is still grateful for his dedication to the country and believes that history will have a fair and objective evaluation,” a statement from Mr. Ma’s office said.

Physically imposing and charismatic, Mr. Lee spanned Taiwan’s modern history and was native to the island, unlike many who arrived with Chiang Kai-shek in 1949, at the end of the Chinese civil war.

At times gruff, at times personable, he left little doubt he was the man in charge in almost any setting.

“A leader must be tough and strong enough so he can put an end to disputes and chaotic situations,” he wrote in his autobiography.

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He was born in a farming community near Taipei on Jan. 15, 1923, near the midpoint of Japan’s half-century colonial rule. The son of a Japanese police aide, he volunteered in the Imperial Japanese Army and returned to Taiwan as a newly commissioned second lieutenant to help man an anti-aircraft battery.

He earned degrees in Japan and Taiwan, as well as at Iowa State University and Cornell University in New York. He worked for the U.S.-sponsored Joint Commission on Rural Reconstruction, which sought to encourage land reform and modernize Taiwanese agriculture. He was a member of overwhelmingly Buddhist Taiwan’s Christian minority.

In 1971, Mr. Lee joined the governing Nationalist Party. As a descendant of the people who migrated to the island from China in the 17th and 18th centuries, he was part of the party’s effort to broaden its base beyond the 1949 arrivals from the mainland. He was Taipei mayor, Taiwan province governor and vice-president before succeeding to the presidency in 1988.

In his early years as president, Mr. Lee met significant resistance from Nationalist hard-liners who favoured the party’s tradition of mainlander domination and resented Mr. Lee’s native status. He beat back the resistance, largely by giving his detractors important political positions.

In 1990, Mr. Lee signalled his support for student demands for direct elections of Taiwan’s president and vice-president and the end of reserving legislative seats to represent districts on the Chinese mainland. The following year, he oversaw the dismantling of emergency laws put into effect by Chiang Kai-shek’s government, effectively reversing the Nationalists’ long-standing goal of returning to the mainland and removing the Communists from power.

Communist China saw the democratic steps as a direct threat to its claim to Taiwan, and its anger was exacerbated when Mr. Lee visited the United States in 1995. To Beijing, Mr. Lee’s visit to Cornell signalled the U.S. was willing to accord special recognition to the ruler of a “renegade” Chinese province.

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The U.S. made sure Mr. Lee did not meet with high-ranking American officials, including then-president Bill Clinton, but its attempts to dampen Chinese anger were unsuccessful.

China soon began a series of threatening military manoeuvres off the coast of mainland Fujian province that included the firing of missiles just off Taiwan’s coast. More missiles were fired immediately before the March, 1996, presidential elections, and the U.S. response was to send aircraft carrier battle groups to Taiwan’s east coast in a show of support. The Taiwanese were uncowed and the elections went ahead, with Mr. Lee victorious.

In a celebrated interview in late 1996, Mr. Lee declared that relations between Taiwan and China had the character of relations between two separate states. This was heresy, not only in the eyes of Beijing, but also for many Nationalists, who continued to see Taiwan as part of China, and looked forward to eventual union between the sides, though not necessarily under Communist control.

In 2000, Taiwan elected Chen Shui-bian of the opposition Democratic Progressive Party as president, ending a half-century of Nationalist monopoly. His election was virtually guaranteed by a split in the Nationalist Party, which had two representatives in the race. The retiring Mr. Lee had supported one of them but was still blamed for the split, and the party moved to expel him.

In 2001, supporters of Mr. Lee formed a new pro-independence party. The Taiwan Solidarity Union also wanted to break the cultural and political connection between the island and the mainland.

Mr. Lee himself backed away from wanting a formal declaration of independence for Taiwan, insisting it already was, given the island was not Chinese Communist-controlled.

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In 2012, he backed independence-minded candidate Ms. Tsai of the DPP, who lost to Mr. Ma, an avatar of closer ties between China and Taiwan.

Ms. Tsai ran again and was elected in 2016, upping tensions again with China. Mr. Lee was ailing by that time and played little role in the election. Ms. Tsai won re-election this year by a healthy margin over her Nationalist challenger.

Mr. Lee leaves his wife of seven decades, Tseng Wen-hui, and their two daughters. A son died in 1982 from cancer.

There was no immediate announcement about funeral arrangements.

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