More than two centuries after Chang and Eng Bunker became famous as the world’s first celebrity conjoined twins, a new pair has captured public attention: Valeria and Camila. With a lifestyle and appearance reminiscent of a reality TV show, their rise to fame is a testament to modern social media culture.

Unlike the Bunker twins, who endured a life of exploitation in 19th-century traveling circuses, Valeria and Camila face scrutiny and fascination through the lens of social media, far removed from the confines of a straw-strewn trailer.

In just two months on Instagram, they’ve attracted over 293,000 followers. However, many followers were surprised to discover recently that these ‘twins’ are not real individuals but rather AI-generated personas.

The digital duo shares a single body and frequently posts images and videos of themselves posing for the camera, often in bikinis, and mingling with equally glamorous virtual friends.

In one particular photo, they are seen outside a pub wearing a T-shirt emblazoned with the word ‘Fetish,’ adding to their provocative online presence.

Valeria and Camila exemplify the burgeoning trend of AI-generated influencers, offering a glimpse into a digital future that some find unsettling. Their portrayal, which sensationalizes one of the world’s most poignant and feared congenital conditions, raises important ethical questions.

Beyond the ethical concerns of not originally disclosing that the ‘twins’ are AI-generated, experts have warned that the reality of life as a conjoined twin is a complex experience that goes far beyond public curiosity or social media spectacle.

While some conjoined twins, like Abby and Brittany Hensel, have achieved a level of normalcy through coordination, their lives are defined by daily physical, logistical and emotional challenges.

Throughout their lives, conjoined twins face severe, complex medical issues, including breathing difficulties, cardiac defects, digestive issues and musculoskeletal deformities like scoliosis. 

Conjoined twins often require multiple subsequent operations to correct orthopaedic, urological or neurosurgical issues as they grow.

The overall survival rate is low, often cited between five and 25 per cent, with many not surviving the neonatal stage.

Lonnie Somers, founder and chair of Fetal Health Foundation, spoke to the Daily Mail about the serious morbidity challenges faced by conjoined twins, as well as his concerns about the AI influencers. 

What are conjoined twins?  

Conjoined twins occur when siblings have their skin or internal organs fused. 

Explaining how conjoined twins form in the womb, Mr Somers says: ‘Conjoined twins are identical twins, also called monozygotic twins. 

‘With monozygotic twins, they occur when a single fertilised egg splits. 

‘In some cases, that process happens late and not completely, resulting in the twins being conjoined.’

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.

They are most often joined at the chest, abdomen or pelvis and around five per cent are joined at the head.

Conjoined twins can be diagnosed early in the pregnancy using an ultrasound. 

They must always be delivered by caesarean section, which can carry certain maternal risks, including infection, loss of blood, blood clots, organ injury and risks to future pregnancies. Other risks include miscarriage, preterm birth and neonatal death.

‘Sadly, the morbidity rate is almost 100 per cent, and the mortality rate is 50 per cent within the first few hours of birth,’ says Mr Somers.

‘Of that, the overall survival rate is around five to 25 per cent. Of those, only about 25 per cent are candidates for separation surgery. It is a very serious condition.’

Classification is based on the site of union, with types including thoracopagus (chest), omphalopagus (abdomen), and craniopagus (head). 

Conjoined twins are rare, representing about one in every 500,000 live births in the UK, meaning one set of conjoined twins is born each year in Britain, on average. 

The most famous pair of conjoined twins was Chang and Eng Bunker, who were born in 1811 and travelled with PT Barnum’s circus. They were born in Siam and were known as the Siamese twins.

In the 19th and early 20th centuries, audiences often paid to gawk at people with anatomical curiosities in circuses and fairs. The brothers capitalised on this peculiar trend.

According to the Guinness World Records, the Bunker twins had 21 children between them – a record for the most children born to conjoined twins. 

Conjoined twins Daisy and Violet Hilton were also entertainers in the 20th century.

The Brighton-born twins achieved fame as entertainers in the United States, particularly during the 1920s and 1930s. 

Joined at the hip and buttocks, they were primarily known as vaudeville and sideshow performers, later appearing in films such as Freaks and the exploitation film Chained for Life.

When are conjoined twins separated?  

Some conjoined twins have separation surgery. Others remain connected for the rest of their lives. 

The success of separation surgery depends on where the twins are joined. 

Doctors can only tell which organs the siblings share, and therefore plan surgery, after they are born.  At least one twin survives 75 per cent of the time. 

Separation surgery is highly complex, often requiring dozens of specialists and more than 18 hours in surgery. 

Surgeries are typically delayed until the conjoined twins are around 9 to 12 months old to allow for growth, though emergency procedures may occur. 

The procedure carries high risks and, while often successful in improving long-term quality of life, it may be deemed too dangerous if crucial organs like the heart are shared.  

‘For families, as you can imagine, it is an intense emotional time from diagnosis during pregnancy, the emotional stress of survival, if separation can be done, and the intense round-the-clock care (regardless of remaining conjoined or separated),’ said Mr Somers.

‘There is also an immense financial strain on families, the impact on any siblings and the overall psychological and social challenges.’

Great Ormond Street Hospital is said to have separated more conjoined twins than any other hospital in the world.

The hospital performed its first successful separation of conjoined twins in 1985 and has cared for 38 sets in total.

There are times when separation surgery could create life-threatening risks or cause significant medical issues. For example, surgical separation may not be an option if the babies share vital organs. 

This is the case for Brittany and Abby Hensel, who, from the waist down, share all of their organs, including the intestines, bladder and reproductive organs.

They have two spines (which join at the pelvis), two hearts, two oesophagi, 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.

While they were born with three arms, one was removed surgically.

The twins first gained fame in April 1996, at age five, following appearances on The Oprah Winfrey Show and a Life magazine cover story. 

They later had their own TLC reality series, Abby & Brittany, which documented their life after university.

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 swimming and driving.

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. 

They share one body but live as two separate individuals. In 2021, Abby married Josh Bowling, while Brittany did not.

There is only one other set of twins living in the world with the same condition – brothers Ayşe and Sema Tanrıkulu, who were born in Turkey in 2000.

‘Generally, conjoined twins will face breathing difficulties, mobility limitations, heart issues, bone deformations (especially in the back, such as scoliosis), often chronic pain and need specialised care,’ says Mr Somers. 

But advances in modern medicine have meant that conjoined twins are more likely to live into adulthood and have a better quality of life. 

Lori and George Schappell held the record as the world’s oldest conjoined twins, despite being joined at the head with shared brain tissue. 

In 2007, George came out as transgender, making them the first same-sex conjoined twins to identify as different genders. 

The siblings passed away aged 62 in April 2024 – defying doctors’ estimations that they wouldn’t live beyond the age of 30. 

When the pair were first born, medical science was not advanced enough to separate the craniopagus twins.

But even when separation became theoretically possible – as their brains were not fused – the twins were adamant about staying together.

The twins spent their lives facing in opposite directions, with Lori working in the hospital industry while George pursued a successful singing career.

Advanced 3D imaging (CT and MRI scans) and 3D printing of anatomical models allow surgeons to map complex, shared anatomy, such as organs or brain tissue, before surgery, improving accuracy and reducing risks. 

The use of tissue expanders to create extra skin for covering exposed areas after separation, along with advanced anaesthesia, has improved survival rates. 

Complex, 24-hour operations involving dozens of specialists are now more common, leading to higher success rates in previously ‘impossible’ cases.   

‘While I fully support free speech, it is concerning and sad to see these AI conjoined twin influencers,’ says Mr Somers. 

‘It looks to be glamorising and sexualizing a very serious condition that has a high rate of mortality and nearly 100 per cent morbidity. 

‘It also incorrectly portrays the real-life struggles of conjoined twin survivors. It is sickening that someone is likely profiting off glamorising a serious physical and medical condition.’