Gloria Cuttino knows she was born. She just can't prove it.
In a frustrating circumstance that's surprisingly common among poor African Americans born in the South in the mid-20th century, Cuttino has no birth certificate.
That wasn't a great hindrance for much of her life, but it's a bigger problem these days, when the post-9/11 world insists on identification cards with photographs, even for non-drivers.
Without a birth certificate (among other documents) in Pennsylvania, residents can't get state-issued ID cards. Without ID cards, officials say, people can't get jobs, access Social Security benefits, get medical benefits, have surgery, get medicine, access housing benefits, open bank accounts, or board planes or even intercity buses.
For Cuttino, who believes she's 62, the lack of photo ID means she can't access subsidized housing, for which she would qualify because her income is below the federal poverty level.
Injured from working for years as a nursing assistant, Cuttino receives federal disability payments, and moves back and forth between the homes of two grown sons in Germantown and Northeast Philadelphia.
It's ironic, said Cuttino, that a person who has had to bear so much of what's hard and awful in life hasn't even officially been born.
"I am who I am," Cuttino said. "I just need proof."
For decades, many low-income African American women in the South gave birth in family homes instead of hospitals, aided by midwives, said Nicole Austin-Hillery, director of the Washington office of the Brennan Center for Justice at the New York University School of Law, a nonpartisan law and policy institute. The births often went unrecorded.
Tens of thousands of babies were born off the grid, real people with the status of ghosts.
Quite often, the white establishment running records offices in the Jim Crow South weren't all that eager to record the births anyway, Austin-Hillery said.
And, in some cases, pregnant black women were denied entrance to hospitals, historians have written.
Cuttino was probably born in her family's home in Summerville, S.C., most likely in 1952, and was never issued a birth certificate, said Niki Ludt, director of the legal center at Face to Face, a social-services agency in Germantown. (The agency gained renown when a client, Viviette Applewhite, 94, was lead plaintiff in a lawsuit that helped defeat Pennsylvania's voter-identification law this year.)
The family moved to Philadelphia when Cuttino was about 5, part of the so-called Great Migration between 1915 and 1970, when about six million African Americans moved to the cities of the North from the rural South.
Cuttino's mother died when Cuttino was about 16. The teenager took care of two of her younger siblings, as well as her father, who was in and out of hospitals with various ailments.
In the absence of a birth certificate, one has to be "created," Ludt said. In Cuttino's case, that was done by providing South Carolina officials with proof of "birth facts."
But as with so much in Cuttino's life, nothing is easy or straightforward.
Ludt researched official documents connected to Cuttino's life to present as birth facts. Unfortunately, there are inconsistencies in the documents.
For example, school records show a different year than 1952 for Cuttino's birth, an error her parents made. And Cuttino herself erred when she wrote on an application for a Social Security card in 1968 that she was born in Philadelphia. It was something she misunderstood from her mother, who was then dead.
The inconsistencies have precluded South Carolina officials from creating a birth certificate for Cuttino.
In some cases, people such as Cuttino have no choice but to appear before a judge and ask for an order to create a birth certificate.
"It's such a mess," Ludt said. "Gloria is part of a hidden population that's having trouble getting IDs for the first time.
"This twists my mind."
As many as 7 percent of U.S. citizens - 13 million people - do not have access to the documents that prove their birth and citizenship, according to research by the Brennan Center.
And people with low incomes are more than twice as likely to lack documentation such as a birth certificate that proves their citizenship, according to the center.
That's partly because of the Southern midwife problem. But even for people who can access their birth certificates, it costs money to secure documents, and poor people preoccupied with food, rent, and heat rarely have the cash to get their papers in order, Austin-Hillery said.
Poor people are often transitory, having to move from place to place to survive, and it's not uncommon for them to misplace their important papers or lose them to theft, experts say.
Ludt offers free legal help to Cuttino and others, but it's never easy. Often, bureaucracy run amok is the problem, she said.
In one case, Ludt said, a low-income client of hers born in Charlotte, N.C., was denied a created birth certificate despite presenting four acceptable documents proving birth.
The reason? Though the documents indeed said the person was born in Charlotte, they didn't include the name of the county - Mecklenburg - as stipulated by law. As a result, Ludt's client's documents were not considered.
"It's an example of bureaucratic idiocy," she said. "How could it not be Mecklenburg County if it's Charlotte, N.C.?"
To get a state-issued ID, a person needs a Social Security card and proof of residency, along with a birth certificate. He or she must also come up with a check or money order for $13.50.
That can be a large sum to poor people, and Philadelphia homeless advocate Adam Bruckner has been raising money to help people pay the tariff.
That price will soon double, however, rising to $27.50 on April 1 as part of additional revenue being generated to improve transportation in the commonwealth, said a spokesman for the state Department of Transportation, which issues the IDs.
"It's pretty scary," Bruckner said. "That's a daunting amount of money to raise for people."
Photo ID cards have become more the norm since the attacks of Sept. 11, 2001, Ludt said, as Americans tighten security everywhere.
But, Austin-Hillery said, there are other reasons the cards have gained traction throughout America.
They're part of a "movement afoot to exclude certain people from accessing benefits," she said - a way to make it so hard for the poor to get help they give up trying.
For her part, Ludt said, she won't abandon Cuttino. "We strive to have our people feel heard and validated," she said.
For people such as Cuttino, who can't even prove she was born, that can be quite a comfort. But still, as she struggles to get a certificate attesting to her birth more than 60 years ago, she's left with a difficult question:
"In this country, how the hell could this happen?"