(New York, NY) — A criminal case against Chinese human rights activist Li Qiaochu was reportedly formally approved by state prosecutors Monday, a development which PEN America decries as an escalation in the attempt to punish her for her speech.

Li is a women’s and labor rights activist, as well as the partner of Xu Zhiyong, the detained activist and essayist currently facing charges of “subversion.” On February 6, Li was detained in Beijing and taken to Linyi Detention Center, where Xu is also being held. At that time, PEN America called her detention “an appalling escalation in the attempt to silence and punish Li” for continuing her vocal advocacy for Xu’s case.

On Monday, it was reported that Linyi City Procuratorate, the local prosecutorial body, approved Li’s case for formal arrest on charges of “inciting subversion.” Such charges can result in up to 15 years imprisonment. Li is reportedly currently detained at the Linyi People’s Hospital. It is reported that Li suffers from hyperthyroidism, heart disease, and depression.

“With this newest step to advance the charges against Li, authorities are piling injustice on top of injustice,” said Summer Lopez, senior director of free expression programs at PEN America. “Li is being punished for having the temerity to refuse to be silent about the abuse that both she and Xu have suffered. We are particularly concerned about Li’s health, and we fear that Li may be experiencing abusive and degrading treatment as we speak. We call for Li’s immediate release, and for Linyi officials to reverse this unjust decision.”

Prior to Li’s detention, police had warned her against continuing to speak out about Xu, after she had continued to speak about him and the charges he is facing. In December, Li accepted the PEN/Barbey Freedom to Write Award on Xu’s behalf for PEN America’s 2020 Literary Gala. The Freedom to Write Award is awarded yearly to an imprisoned writer who has been targeted for their free expression.

Last year, Li spent four months in secret detention before her release on bail. Earlier this year, Li released an account of her time in detention—an experience that included 24/7 surveillance, constant abuse, and negotiation with authorities over her own medical needs. At one point, she reports a guard saying to her, “If you think you can kill yourself in this kind of place, you will end up making your life worse than death.”