Smith is in London for the opening of a new exhibition of work by the gay photographer Robert Mapplethorpe, her collaborator and first serious lover, who died in 1989. One room is devoted to the gelatin prints he made of Smith, including the cover of her 1975 album Horses - a stark black-and white portrait of an androgynous Patti in a white shirt.
Wandering round the gallery, Smith is visibly moved. Still dressed in her trademark man's shirt and trousers, with granny specs, she looks far younger than 60. Our conversation ranges from politics (she loathes the Bush administration), to environmentalism and cosmetic surgery. "I'm not the kind of musician who can sit and talk to you about chords," she warns.
Smith is rock's greatest woman artist. Her lovers include the actor and writer Sam Shepard; producer Todd Rundgren; and Tom Verlaine, frontman of Television. She was married to musician Fred "Sonic" Smith for 15 years before his death. More recently she was involved with musician Oliver Ray, 30 years her junior. But it is Mapplethorpe who remains the towering influence. When he died of an Aids-related disease, she wrote an extraordinary poem, "The Coral Sea", about their relationship.
Mapplethorpe would have been 60 in November. There is a retrospective of his work in Edinburgh. In contrast with his usual S&M images, those of Smith are generous and woman-friendly. "When I look at our pictures there's always a softness because even though we caused each other a lot of pain, we really loved each other."
Smith met Mapplethorpe in 1967 in New York. They lived together at the Chelsea Hotel and hung out with William Burroughs. Smith inspired Mapplethorpe, a sculptor, to take up photography. He persuaded Smith to perform her poetry live. In 1975 he paid for her first single to be recorded. With Horses, which fused Smith's free-form poetry with proto-punk rock, she blew the door open for girls with guitars.
The androgyny was never a pose. "I picked my clothes off the floor and we took the pictures. But I loved the way that manner of dressing expressed my version of Baudelaire and the 19th-century poets. When I look at the cover of Horses, I don't find it unfeminine at all: it's like a declaration of independence."
What does Smith think of today's soft-porn chic, embodied by the likes of Paris Hilton? "It's not even femininity. We're being sold an image of how to exploit one's self to get attention. It's about redesigning the surface. I've been horrified by all these articles about Botox and plastic surgery as if it's a normal thing."
A friend recently showed her how digital retouching can take 20lbs off someone. "This isn't some joke or unfortunate thing that happened to a newscaster in America. This happens continually. Young girls are getting anorexic because they don't look like people in magazines who often don't even look like that."
Smith has retired twice from performing, once when she broke neck vertebrae falling off stage, and then in the early 1980s to bring up her son and daughter with Sonic. "I had to live a life where, like everybody else, I did tons of laundry and cleaned toilet bowls, changed hundreds of diapers and nursed children. I learned a lot."
In 1994, while she was still mourning the death of Mapplethorpe, her husband and younger brother both died of heart attacks in their forties, and Smith broke down. She has since become an active supporter of psychiatric treatment.
One senses that her life and music are full of ghosts. "I keep my communication lines with the people I have lost." But her political engagement is total. She opposed the war in Iraq and has just written a new song, "Qana", protesting against Israel's bombardment of south Lebanon.
"We have gone backwards in terms of the anti-war movement, in terms of understanding there are no righteous wars. We've got to take note of how we are destroying our environment. Nature is the real woman scorned. We're going to see things that we've never dreamed of. America is still shaking in its boots because more than 2,000 people were killed in the World Trade Center. Well, this is a terrible thing, but over 40,000 Iraqi citizens have been killed since September 11 and 100,000 died in the tsunami."
Smith's music has always been for outsiders. "As a teenager I was the worst wallflower weirdo." She wore an eyepatch for a tremor her family could not afford to have corrected. She contracted tuberculosis and scarlet fever, which caused her to experience hallucinations. Her saviour was literature: influences on her music include Rimbaud and Blake as much as Keith Richards or Bob Dylan.
These days, Smith lives "the simple life of the artist", touring when she wants to, taking photographs and making albums. This week she will be performing The Coral Sea with music by Kevin Shields of My Bloody Valentine. "I wrote it when I was absolutely grieving for Robert and it is encoded with our whole life: from the gold signet ring carved out of a nugget to the purple dish in the shape of cow that my mother gave him in 1969.
"In fact," she brightens, "after Robert died, Sotheby's was dividing up the saleable items, and they were very puzzled by the cow. My mother cried when she heard that he'd kept it."
Smith's mother sounds a real character. "She had a lot of tragedy in her life, but she was not a depressed person. In fact," she laughs, "she always wanted me to do medleys like Frank Sinatra. She'd say, 'I've figured out a medley for you. You go from "Horses" to "Gloria" to "Rock N Roll Nigger".' I said: 'Mommy, they're the three longest, most challenging, vigorous songs I do!' But actually, I would do it occasionally when she came to see me."
Robert Mapplethorpe: Still Moving & Lady is at Alison Jacques Gallery, London W1, 020 7287 7675, until 7 October. Tomorrow and Tuesday, Patti Smith presents 'The Coral Sea' at Queen Elizabeth Hall, South Bank. Tickets: 08703 800400
BIOGRAPHY: A voice raised in protest
Born: Patricia Lee Smith in Chicago, 1946. Left formal education at 16 and went to work in a factory
1967: Moved to New York and met Robert Mapplethorpe
1974: Formed Patti Smith Group
1975: Released debut album Horses, produced by John Cale
1979: Released fourth album, Wave, and married Fred "Sonic" Smith, guitarist for Detroit band MC5. Retired to bring up a family
1988: Released solo album, Dream of Life
1996: Returned to performing with the release of the album Gone Again, featuring a tribute to Kurt Cobain
2004-2005: Campaigned with Ralph Nader to end the Iraq war and impeach President Bush. Released critically acclaimed album Trampin'
2005: Toured with Bob Dylan. Curated London's Meltdown Festival, where she performed Horses in its entirety for 30th anniversary
2006: Recorded "Qana", protesting against Israel's bombardment of south Lebanon
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