How ultra-rare conjoined twins Abby and Brittany Hensel drive, eat and have sex

America's most famous conjoined twins are back in the news today after it was revealed one of them had gotten married.

Abby Hensel - who shot to fame on a reality TV series with sister Brittany - quietly tied the knot with an army veteran in 2021. 

It has led many to speculate how the sisters carry out day-to-day activities, including intimate ones.

Abby and Brittany, 34, from Minnesota, are one of only a handful of sets of dicephalus twins in history, meaning they have two heads and two hearts but share a single body from the waist down - including their genitals.

Although Brittany - the left twin - can't feel anything on the right side of the body and Abigail - the right twin - can't feel anything on her left, instinctively their limbs move as if coordinated by one person, even when typing e-mails on the computer.

This means they are able to do most things a nonconjoined person can do, including driving and cooking, and they've also mastered things like playing the piano.

For tasks such as replying to emails, they use the keyboard and respond as one, anticipating each other's feelings with little verbal communication between them.

As for driving, the twins passed their driving test on their 16th birthday - a mind-boggling feat of teamwork with each twin using one arm to control the steering wheel.

'Abby takes over the pedals and the shifter, we both steer, and I take over the blinker and the lights,' Brittany said.

When they took their driving test, their mother Patty, a registered nurse, conceded there could have been a problem.

She said: 'I don't know what would happen if they got pulled over for speeding. Would they each get a ticket or just Abby because it's her foot on the accelerator?'

The twins also stunned doctors with their astonishing co-ordination while playing the piano, with Abigail taking the right-hand parts and Brittany the left. 

Growing up, they enjoyed sports such as bowling, volleyball, cycling, softball and swimming.

But how the pair handle intimacy is the question many are intrigued to know the answer to.

One may assume that, like everyone else, conjoined twins experience sexual desires - but some don't.

Conjoined twins Lupita and Carmen Andrare, 23, born in Mexico but living in Connecticut, US, have the same physical makeup to Abby and Brittany.

While Carmen has a boyfriend named Daniel, Lupita is asexual, meaning she is not sexually attracted to others.

But even Carmen and Daniel are not sexually intimate, with Carmen describing their bond as more of a 'close friendship' in an interview with Jubilee. 

Famous conjoined twins Chang and Eng Bunker, from Thailand, were joined only by a bit of liver and skin, and so had separate genitals.

They both married separately, and judging by the fact that Chang had ten children, while Eng had 12, it is safe to say they both had sex.

People have speculated that while one was 'busy' with their wife, the other one must have tried to sleep, read or ignore what was going on, to give as much privacy and dignity as possible.

With Abby and Brittany, who share the bottom-half of their body, it is slightly different.

Like most conjoined twins, Abby and Brittany have never publicly spoken about their sex life, despite immense public curiosity.

As the Hensel twins share one set of genitals, they would both feel any touching down there, wrote Alice Dreger, a professor of clinical medical humanities and bioethics at Northwestern University's Feinberg School of Medicine, in The Atlantic.

As for whether both would experience an orgasm at the same time, we don't know, she said.

Because there is significant variability of each twin's 'feeling' in different body parts, it is 'hard to guess how any conjoinment will turn out in practice,' Professor Derger said.

Some have speculated that dicephalus twins would both experience a simultaneous orgasm, given that they share the same sexual organ, with the same nerves, muscles and blood vessels.

What about kissing? Will both sisters feel it if one is kissed? 

Professor Dreger wrote: 'The biology geek in me wants to answer that the happy hormones that come from a good kiss probably work their way to both brains. 

'But the student of human nature in me says that when your sister gets kissed and you don’t, it’s quite possible that the unhappy hormones end up standing at the gate.'

Professor Dreger said that from her studies, she assumes conjoined twins likely have less sex than average people, not just because finding a partner is harder but because they may not need romantic partners to have sex with as much as everyone else does.

Over the years, she added, many twins have described their experience of being conjoined as like being attached to a soul mate, so they may feel less need for a romantic relationship with another person.

Another looming question is will the Hensel's have children - a choice they must both make in tandem because they share one reproductive system? 

There is no medical reason why they shouldn't be able to have children, and they have in the past said they would like to start a family.

As for eating, the twins tend to have separate meals, but sometimes share a single meal for convenience, for example, each taking a bite out of the same hot dog.

The twins have two digestive systems including two separate esophagus' and stomachs, but share a large intestine, small intestine, bladder and excretion system.

It is rare for twins conjoined the way that Abby and Brittany are to survive into adulthood, but despite this they are in good health, without heart defects or organ failure.

When the Hensel twins were born on March 7, 1990, in Minnesota, doctors warned their parents Patty and Mike that they were unlikely to survive the night. But that prediction was to prove wildly wrong.

Their parents Patty and Mike never once considered having the twins separated, because of the risk both might die or be left with such severe disabilities their quality of life would be compromised.

Separation surgery success for conjoined twins depends on where the twins are joined. 

According to previous reports, only once have the Hensel twins talked about separation - in childhood - when Abigail became bored and restless after Brittany fell ill with pneumonia and was confined to bed.

She started to suggest being separated from her sister, but when Brittany began to cry Abigail reassured her that everything was fine and that they'd never be parted.

Conjoined twins occur when siblings have their skin or internal organs fused together, which affects around one in 200,000 live births.

It is caused by a fertilized egg beginning to split into two embryos a few weeks after conception, but the process stops before it is complete.

The most common type is twins joined at the chest or abdomen.

Doctors can only tell which organs the siblings share, and therefore plan surgery, after they are born. At least one twin survives 75 percent of the time. Just one set of twins in every 40,000 is born connected in some way to each other and only one per cent of those survive beyond the first year.

The Hensel girls are the rarest form of conjoined twins, the result of a single fertilized egg which failed to separate properly in the womb, resulting in dicephalic parapagus - where the twins have two heads and a single body with two arms and two legs.

They have two spines (which join at the pelvis), two hearts, two esophagi, two stomachs, three kidneys, two gall bladders, four lungs (two of which are joined), one liver, one ribcage, a shared circulatory system and partially shared nervous systems.

From the waist down, all organs, including the intestine, bladder and reproductive organs, are shared.

In infancy, a third undeveloped arm was removed from the twins' chest and aged 12 they underwent surgery to correct scoliosis - curvature of the spine - and expand their chest cavity to prevent future breathing difficulties.

Abby and Brittany face a common stigma that they are one person instead of two.

When growing up, they, like many twins, had very different personalities and tastes. Abigail, the feisty, stubborn one, liked orange juice for breakfast, while Brittany, the joker of the family, would only touch milk.

Speaking previously, Brittany, who alongside her sibling graduated from Bethel University in Minnesota, said: 'Believe me, we are totally different people.'

It has not been unknown for the twins to go out in a specially made top with two different necklines - to reflect their unique tastes - and leggings with each leg a contrasting color and a different shoe on each foot.