Conjoined twins, also known as Siamese twins, are two individuals who are physically connected. They share a fusion along their lower back (pygopagus), pelvis, upper and lower digestive tracts, and some of the liver and genital organs.
Despite their unique anatomy, many sets of conjoined twins live normal lives. They inspire us by proving that love and intimacy can transcend physical boundaries.
What Causes Conjoined Twins?
While no one knows exactly what causes conjoined twins, it is thought that the condition may be the result of an incomplete splitting or fusion of embryonic cells during pregnancy. Identical twins are usually formed when a single fertilized egg splits into two identical fetuses, but sometimes the embryonic cells don’t completely separate or fuse as they should. Approximately 28% of conjoined twin pregnancies end in miscarriage or stillbirth, and 54% of these twins die shortly after birth.
When a pair of conjoined twins survive, they’re often assigned a gender at birth, with about 70% being female and 30% male. The most common type of conjoined twins are thoracopagus (fused from the thorax to the belly button) and omphalopagus (fused from the abdomen to the pelvis). Craniopagus twins share a skull and meninges, but they can be differentiated by the presence or absence of rudimentary facial features. This is the least complicated type of conjoined twin.
In rare cases, a pair of conjoined twins will be fused from the hips to the lower abdomen. This form is called rachipagus. While these twins can be separated, the procedure is dangerous and requires significant medical care. In most cases, doctors will recommend delayed separation so that the twins can grow and develop. This approach is considered the safest option for both of the twins, who will have a greater chance of survival after separation.
What are the Complications of Conjoined Twins?
Pregnancy with conjoined twins increases the risk of serious complications. Around 28% of these twins die during pregnancy or soon after birth, and only 18% live beyond 24 hours after being born. The outlook for surviving conjoined twins depends on where they are joined and which organs or structures they share.
Conjoined twins develop when an early embryo only partially separates into two babies (monozygotic twins). Scientists don’t know what causes the incomplete splitting, but they believe that either the twins fuse together while developing or that one of them reattaches to the other during development.
Identical twins are more likely to be conjoined than fraternal twins. However, if the twins are joined at the chest (thoracopagus), they face each other and are connected in the ribcage area, usually sharing a heart. They also share a diaphragm and upper abdominal wall and might have four arms and legs each. These twins account for 75% of all conjoined twins.
Other types of conjoined twins include those joined at the abdomen (omphalopagus or xiphopagus). These twins face each other and are connected below the sternum, sharing a liver, an intestine, a genital tract and the lower abdominal wall. This type accounts for 20% of all conjoined twins. If your twins are thoracopagus or omphalopagus, the medical team may recommend immediate separation surgery to save their lives. Otherwise, the medical team might delay separation until the twins are older and healthier.
How Can Conjoined Twins Have Intimate Relationships?
Conjoined twins can build intimate relationships, though they face unique challenges. Navigating intimacy requires open communication and establishing consent and boundaries. It also involves exploring and adapting positions and techniques to fit their physical limitations and emotional comfort levels. It is important to prioritize understanding and empathy in order to create a positive experience for both twins.
Because of their connection, the lives of conjoined twins are fascinating to many people. They share sensations in various body parts and can feel each other’s thoughts, words, and emotions. For example, the craniopagus twins (twins joined at the top of their heads) can sense each other’s movements and have a mutual reaction to certain things, like the taste of ketchup. However, it’s hard to predict how they would feel in other body parts due to the variability.
Although some people may find the idea of conjoined twins having sex to be a bit odd, it is possible for them to have sexual and romantic experiences with other people. It is also possible for them to fulfill their sexual desires and engage in masturbation, although some of these activities require the use of pillows or other equipment to provide comfort and stability. It is important to avoid stigmatizing or fetishizing these individuals by promoting inclusivity and understanding in society. Additionally, it is crucial to respect the autonomy and agency of these twins in their intimate relationships and avoid judging them based on their physical condition.
How Can Conjoined Twins Have Sex?
Many people don’t understand conjoined twins or the challenges they face in intimate relationships. This lack of understanding can contribute to the stigmas and misconceptions that surround them. It can also impact how people treat them. This can be especially true when it comes to sex.
While there aren’t enough sets of conjoined twins to conduct a scientific study on, it seems that most twins who share genitalia have sex separately. However, it’s important to note that this doesn’t mean they feel no sensation at all. When a person is sexually stimulated, hormones are released into the bloodstream. These hormones can affect the way that each twin feels.
It’s also important to remember that conjoined twins have different body structures and sizes. Some twins are joined at the head, while others are joined at the torso or even have an extra limb. This can have a huge impact on their sex lives, as some twins may have limited mobility or flexibility in their shared areas of the body, which can limit how they experience pleasure.
Some conjoined twins, such as the famous Siamese twins Chang and Eng Bunker, married separate men and had children with them. There are other examples of conjoined twins who were separated by only a small portion of their body, such as the dicephalic parapagus twins of Elizabeth and Mary Chulkhurst from England, which lived in the 1500s; or Helen and Judith of Szony, Hungary, born in 1701-1723.
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