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Completely different. Twins have their own personalities and deserve to be treated as individuals. Variations are okay, so long as the names are different enough that most people can't tell that the names are related (like Isabel and Elizabeth). The Same Meaning category can also be quite clever, again, as long as the average person can't immediately guess that there's a theme behind the names (like Hannah and Grace).

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The most barfworthy category isn't mentioned on your list, and that's the Rhyming twinset. Imagine meeting a little Macy and Stacy, or Ronald and Donald. Blech!