One of us: Conjoined twins and the future of normal (review)

Though Alice Domurat Dreger's One of Us is relatively brief, it has far-reaching implications for feminist work on topics such as autonomy, embodiment, normalization, disability, and power. In this accessible and engaging book, Dreger considers conjoined twinning (which she notes is arguably the most extraordinary form of human anatomy) in relation to other forms of anatomy which also defy cultural norms in order to explore the extent to which anatomies limit political and social identities, and in particular, the extent to which a "deformed" or "malformed" anatomy can be regarded only as pitiful. Furthermore, Dreger argues for a politicized understanding of unusual bodies, one which aims to change assumptions made about the people who inhabit such bodies, and by doing so, transform the social context built around them (6).

Two threads of analysis are dominant in Dreger's book. That these two threads run throughout the book also make it highly pertinent for work in the emerging fields of philosophy of disability and disability studies. Dreger, who at one time was Director of Medical Education at the now-defunct Intersex Society of North America (ISNA), agrees with those disability theorists and activists who recognize that the institutional, historical, political, and social circumstances that surround intersexed people and conjoined people have much in common with the circumstances that surround (other) disabled people (e.g., see Tremain 2001; Shildrick 2002). Indeed, she regards the disabled people's movement as the civil rights movement that is most closely associated with the interests of intersexed people and conjoined people (147–55).

One thread of Dreger's analysis constitutes a sociological mapping of the category of conjoined and an ethnographic account of conjoined twins. This line of analysis allows Dreger to explain the forms of embodiment that the category signifies, that is, outline the various configurations that conjoinment can take. In addition, through historical documentation and personal narrative, Dreger introduces a number of twins to show how the subjectivities and personal identities of conjoined people are constructed and the extent to which the desires, frustrations, goals, and perspectives of conjoined people resemble the desires, frustrations, goals, and perspectives of non-conjoined people. This thread of analysis also enables Dreger to uncover the ways that particular assumptions about conjoined twins on the part of "singletons" render conjoined people radically different from themselves. Dreger explains, for instance, that singletons assume that psychosocial individuality requires anatomical individuality, that is, they tend to assume that conjoined twins are trapped by virtue of their embodiment in a way that makes a happy, "normal" life impossible. Dreger points out, however, that "one of the ways in which conjoined twins are like almost everyone else is that they tend to readily accept, and even prefer, the anatomy with which they were born" (7). This self-perception likely will seem bizarre to many singletons because in the current social climate, certain understandings about what it means to be a full-fledged human being work to cast some lives as unliveable.

Nevertheless, Dreger's analysis of this self-perception and of the subjective experiences of conjoined people is quite suggestive for feminist work on autonomy, in general, and relational autonomy, in particular. Although Dreger calls for a more critical discussion of "the limits of individuality" (17–50), she also points out that most conjoined people regard themselves as independent individuals. Medical personnel think that conjoined twins must be separated (ideally at birth), even if this requires sacrificing the life of one twin. Dreger remarks that whereas it appears self-evident to medical personnel that surgical separation of these "unnatural creatures" is essential to each one's well-being and sense of personal identity, among the conjoined people with whom she communicated about her research, there is almost universal agreement that conjoinment is a desired state. In short, as Dreger explains it, conjoined people do not think there is anything fundamentally wrong with their conjoinment and would refuse surgical separation were it...