The Sex Lives of Conjoined Twins

Why does the topic "defy imagination"?

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One thing we know for sure about the sexuality of conjoined twins: People who aren't conjoined are fascinated by it. At least it seems that way, judging by the number of reporters calling me to ask about the sex lives of conjoined twins since the TLC reality show Abby and Brittany went on the air several weeks ago. As I've told callers, although there are no real studies of the sex lives of conjoined twins, we can safely assume that conjoined twins want -- and occasionally feel conflicted about wanting -- sex, as we all do.

But not as conflicted as we singletons seem to feel about them having sex. Typically, people who are close to conjoined twins come to adjust and see them as different but normal; they seem fairly untroubled by the idea of conjoined twins pursuing sex and romance. But those who are watching from afar cannot abide.

The best example of this would probably be the story of Chang and Eng Bunker, "the Siamese Twins," so called because they were from Siam (now Thailand). Chang and Eng were joined by just a bit of liver and some skin. One April day in 1843, Chang married Adelaide Yates, while brother Eng married sister Sallie Yates. Based on the fact that Chang and Adelaide had 10 children, and Eng and Sallie 12, it's fair to say the brothers had sex.

When your sister gets kissed and you don't, it's quite possible that the unhappy hormones end up standing at the gate.

At the autopsy of the Bunker twins, one of the anatomists opined that their active sex lives "shocked the moral sense of the community" -- even though the truth is that the Bunkers' neighbors appeared to have just accepted the situation. A little known fact is that the Bunker wives' father originally objected to his daughters marrying the twins not because they were conjoined, but because they were Asian. (This was, after all, the antebellum American South.)

Yet in the nineteenth century, when doctors discussed whether the twins Millie and Christina McCoy could marry, one spoke for many: "Physically there are no serious objections ... but morally there was a most decided one." When, in the 1930s, Violet Hilton sought to get a marriage license while conjoined to her sister Daisy, she was repeatedly refused.

The same discomfort generally carries through to our own time. When filmmaker Ellen Weissbrod set out to do an A&E Channel program about Lori and Reba Schappell, who are conjoined at the face, Weissbrod showed raw footage of the twins to New Yorkers on the street, without explanation, to gauge their reactions. Upon figuring out what she was looking at, one woman said only, "I mean ... sex ..."

Sex is often mentioned by commentators on conjoinment as one of the beautiful things supposedly made instantaneously horrible by conjoinment. I'm afraid I just laughed when, in writing a book on conjoined twins, I came across this 1984 line by a nurse writing in a medical journal: "Two people never being able to obtain privacy to bathe, excrete, copulate, or eat defies imagination."

Surgeons sometimes openly allude to sexuality as a motivator for separation surgery. In 2002, as soon as he had made the cut separating two little girls joined at the head, the neurosurgeon involved paused to announce to the assembled medical team, "We now have two weddings to go to." Indeed, when I talked to contemporary surgeons about how they decide whether to undertake the substantial risks some separations involve, I found that surgeons had two fears, sort of conjoined: one, that twins would grow up conjoined and thus never have sex; two, that twins would grow up conjoined and actually have sex.

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Alice Dreger is a professor of clinical medical humanities and bioethics at Northwestern University's Feinberg School of Medicine. She has written for The New York Times, The Wall Street Journal, and The Washington Post.

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