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She was born in Wythe County in southwest Virginia and earned a BA in political science from Emory and Henry College, focusing on community organizing. She later attended the John F. Kennedy School of Government at Harvard University.
Atkins relocated to San Diego in 1985 to help her pregnant sister, Tenia Phillips. She ended up staying permanently. She joined the staff of Womancare Health Center as Director of Clinic Services. Atkins served as council representative and policy analyst to Councilmember Christine Kehoe for a number of years. When Kehoe was elected to the state legislature, Atkins was elected to Kehoe's seat, the Third District of the City Council of San Diego, on November 7, 2000. She was reelected in March 2004.
In April 2005 Mayor Dick Murphy resigned due to ethics scandals. Councilmember Michael Zucchet, who was deputy mayor, took over, but three days later, resigned along with Councilmember Ralph Inzunza after they were convicted of wire fraud and Hobbs Act violations. In an emergency vote on July 19, Atkins was chosen by the other five council members to take over as mayor pro-tem for one week. On July 25 they reaffirmed their choice and designated her deputy mayor to serve until Jerry Sanders was sworn in as Mayor December 5.
Atkins was the first openly lesbian mayor of San Diego.
Atkins currently chairs the City Council’s newly formed Committee on Budget and Finance, and is vice chair of the Land Use and Housing Committee, as well as the Natural Resources and Culture committee.
She also represents the City of San Diego at the San Diego Chapter of the League of Cities as well as on the board and executive committee of the Metropolitan Transit System. She sits on the San Diego Association of Governments (SanDAG) Regional Housing Working Group, as an alternate to the Transportation Committee and the Regional Planning Committee, and the City/County Joint Homeless Task Force. She continues to serve on the San Diego River Conservancy as an appointee of former California State Assembly Speaker Herb Wesson.
She lists among her priorities affordable housing, workers' rights, neighborhood revitalization and redevelopment of San Diego's older urban neighborhoods.
Atkins is the recipient of numerous awards, including the Gay and Lesbian Leadership Award from the national Gay & Lesbian Victory Fund in honor of her recent service to the City of San Diego as Deputy Mayor. A 21-year resident of Council District Three, she currently resides in the South Park neighborhood.
"I'm certainly aware of that fact (of San Diego being the largest U.S. city with an openly gay mayor). I know that it has significance for our LGBT community, so it is something that I take seriously. I think it's a huge responsibility, so I'm very much aware of it and I hope that it's a good thing for our community." — Washington Blade