A transgender woman detained in an Elgin mental-health facility has secured access gender-affirming healthcare, possibly setting a precedent for transgender people detained in jails, prisons and mental health centers throughout Illinois.
Mia Kobi-Burks, 37, has been transitioning to female over the last year, after her attorney argued that the Illinois Department of Human Services ( IDHS ) was legally obligated to provide her with transition medical services, he said.
According to experts, her case may pave the way for others who are detained in mental health facilities, jails and prisons in Illinois, as advocates continue to push for gender-related healthcare for transgender inmates throughout the country.
Kobi-Burks was charged in 1993 with the slaying of her mother, father and sister. She was found not guilty by reason of insanity and has since been held in custody at Elgin Mental Health Center.
For years, she has been trying to medically transition to female, she said.
"I think they just didn't understand it because they didn't have a working understanding of what transgender was," Kobi-Burks told Windy City Times. "It's exceedingly difficult to get people to understand that trans is not gay."
But civil-rights attorney Lowell Sachnoff argued her case.
In 2006, Lambda Legal and the American Civil Liberties Union of Illinois filed a federal lawsuit in Wisconsin on behalf of three incarcerated transgender women. The case challenged state law banning access to gender-affirming healthcare like hormone therapy and sexual reassignment surgery. The case went up to the Seventh Circuit Court of Appeals, and the court found that the state was obligated to provide medically necessary transgender care.
The Seventh Circuit Court of Appeals encompasses Illinois, and Sachnoff used that case law to make an argument for Kobi-Burks, he said.
"It's legally absolutely necessary," he said, adding than denying Kobi-Burks care would be cruel and unusual punishment.
According to Sachnoff, Kobi-Burks is undergoing hormone therapy, laser hair removal, psychological treatment and is looking into sexual reassignment surgery.
Januari Smith, communications manager for IDHS, said that the department is unable to comment on Kobi-Burks' medical care due to patient confidentiality laws. But she did confirm that DHS could be legally required to provide prescribed transgender-related healthcare.
"We are mandated to provide medically necessary treatment," Smith said of transgender healthcare. If a physician prescribes transgender medical care, Smith said, the department is legally obligated to provide it.
Dru Levasseur of Lambda Legal was among the lead attorneys on the Wisconsin case. He said that case was intended to set precedent for Illinois and that it might hold weight in states outsides the Seventh Circuit.
"It shouldn't matter why someone is in [custody]," Levasseur said. "The constitution protects them."
Transgender people on the outside are regularly prescribed surgery and other healthcare interventions to affirm their gender identities, but getting that care behind bars has been slow-going work for transgender prison advocates.
High-profile cases like that of WikiLeaks informant Chelsea Manning, who came out as transgender earlier this year, have stirred public debate on the rights of transgender detainees.
But Levasseur and others are hard-pressed to find cases of transgender people detained in prisons and mental health centers that have been allowed to undergo surgery or receive other healthcare beyond hormone therapy.
"I haven't heard of anybody getting gender-confirmation surgery in any place without a court order," said John Knight, LGBT project director at the American Civil Liberties Union of Illinois.
Kobi-Burks is believed to be the first transgender person detained in DHS custody to access transgender healthcare. Her case, however, could be significant for those detained in jails in prisons in Illinois as the same case law applies.
Sachnoff said he believes Kobi-Burks will able undergo sexual reassignment surgery while in custody, but he said he will also be arguing for her release. Kobi-Burks was the victim of family abusive, he said, and she has not acted violently in 17 years.
Kobi-Burks said, thus far, the staff and other patients have been relatively supportive of her transition.
"I still struggle with some of the staff wanting to call me 'he' or whatever because of some of their comfort issues," she said.
Overall, however, she said, she feels the staff has been well-intentioned. She remains housed with men, she said. They, too, have been supportive of her, she said.
