Warning! Spoilers ahead for Malignant.

The concept that Malignant’s biggest twist hinges on – parasitic twins – has sad, real-life connections. The twin reveal turned out to be the answer to the movie’s underlying mystery, which was the identity of the villain, Gabriel. It was made clear early on that Malignant was a departure from other horror movies directed by James Wan.

Malignant, the first horror movie Wan has helmed since 2016’s The Conjuring 2, wasn’t another ghost story filled with jump scares. While the film’s protagonist, Madison (Annabelle Wallis), was seeing strange, frightening occurrences at night, the subject of her fears wasn’t a spirit or a demon, unlike the situation in The Conjuring or Insidious movies. Throughout the movie, Madison and her sister, Sydney (Maddie Hasson), struggled to figure out what was really going in, with several developments being made in the process. Gabriel, originally thought to be an imaginary friend from Madison’s troubled childhood, turned out to be so much more.

Related: Every Horror Movie Still To Come In 2021

His deep connection to Madison's life before her adoption made it seem to viewers he might be a forgotten brother, but this was only part of the truth. In the third act of the divisive James Wan movie, Malignant finally revealed the game-changing secret about who and what Gabriel is. Video of a young Madison filmed at the Simion Research Hospital confirmed the killer Madison kept seeing visions of was her parasitic twin. Here’s what that is, how it’s different in real life, and what the reveal means for a potential Malignant 2.

Malignant's Gabriel Twist Explained

Gabriel in Malignant

In the video watched by Sydney and her mother Jeanne (Susanna Thompson), it was discovered – much to their shock – that Gabriel was a grotesque lifeform attached to Madison’s back. This was followed up by an explanation from Dr. Florence Weaver (Jacqueline McKenzie), who stated Gabriel is Madison’s “parasitic twin, which is made up of hair, teeth, bones, tissues, and muscles. According to her, a parasitic twin is formed when two developing embryos don’t separate properly in the womb. This causes one to become “dominant” and the other to be “underdeveloped”. It’s different from conjoined twins because the “parasitic twin” is dependent on the dominant sibling’s body. They call this relationship “parasitic” because the underdeveloped twin “feeds” on the other.

Gabriel’s ability to take control of her is owed to the fact he and Madison share the same brain. By assuming control, he can essentially put her in “a mental prison”, thus preventing her from taking any action while he’s at the helm. Because of the negative, physical toll he took on Madison’s body when she was a child - played by The Conjuring's Mckenna Grace -  doctors at the hospital were forced to surgically remove as much of Gabriel from her back as they could. Due to concerns that “full removal” would result in her death, Gabriel was kept alive – to an extent. What was left of him was repressed into the back of her skull. The surviving fragment communicated with Madison regularly over the next few years but was prevented from taking direct control until the present-day events of Malignant. Head trauma caused by Madison’s abusive husband “awakened” Gabriel, thus setting his killing spree in motion.

Are Parasitic Twins Real?

Malignant Parasitic Twin Gabriel

The movie does get creative with Gabriel, but his nature as a parasitic twin does have some basis in real life. Parasitic twins basically share the same definition as that outlined by Dr. Weaver in James Wan's Malignant, in that they are created when two embryos don’t experience a full separation during development, with one growing into the dominant, healthy twin. The “parasitic” twin only has a few body parts and organs (if any), and those are vary depending on the case. The twin may just consist of a head, a torso, and a pair of legs that can’t be controlled by the dominant twin. Similar to the issues facing young Madison in Malignant, the existence of a parasitic twin comes with all sorts of medical concerns. Since the human body can’t typically support additional body appendages on a long-term basis, it’s often necessary for the parasitic twin to be removed for the other to live a healthy life. It’s important to point out real-life parasitic twins aren’t conscious, which means they can’t possess their own thoughts and they certainly can’t take control of the host body. Malignant’s Gabriel controlling Annabelle Wallis' Madison is a much more advanced and menacing take on the concept.

Related: HBO Max: Every Movie & TV Show Coming In September 2021

How Gabriel Can Return In Malignant 2

Malignant Gabriel Sketch

During Malignant’s ending, Madison developed the ability to do to Gabriel what he had been doing to her. The scene where they interacted in her mind showed Madison turning the tables by placing him in a “mental prison” of her own creation. Now she understands what’s going on, Madison has what it takes to resist Gabriel’s efforts to seize control. With a newfound confidence, Madison proclaimed she’ll be ready to stop him the next time he tries to emerge. After all, she is the dominant twin, so it makes sense she would have a greater hold over their shared brain. While the odds have shifted in her favor when it comes to their struggle, the ending doesn’t necessarily take Gabriel out of the equation for good. For as long they live, he’ll always be a threat.

Though Malignant 2 hasn’t been announced, comments from James Wan indicate that while a sequel wasn’t planned from the beginning, it is a movie that could potentially spawn a franchise. Plus, Gabriel returning is possible, since his consciousness being repressed leaves the door open for him to take over at a later date. This very idea was teased in Malignant’s final shot, which showed a lamp and a flickering light. Madison thinks she can stop him, but the constant vigilance needed to keep him at bay will be difficult to maintain. There may be situations in the years to come that Gabriel will be able to take advantage of, such as Madison experiencing an emotional breakdown, another head injury, or a moment of weakness. If Madison lets her guard down even once, Gabriel could return in Malignant 2 to plague his dominant twin and her sister once again.

More: Fall 2021 Movie Preview: Every Movie Releasing (And Where To Watch Them)