Identical tells the story of identical twin sisters, Kaeleigh and Raeanne Gardella. From the onset of the book, it is clear that both teenagers have a difficult life. They are forced to navigate a treacherous, oftentimes traumatic, family environment.
At first glance, the Gardella family is outwardly successful, with a lot going for them. The girl's father is a prominent, well-respected judge; their mother is a politician. However, things are different than they first appear on the surface. Their mother is frequently absent due to her political ambitions. As a way to cope with her personal demons, she resorts to using alcohol. Meanwhile, after getting into a terrible car accident, the girl's father starts to sexually abuse Kaeleigh.
Internally, Raeanne is aware of the abuse that her sister endures on an almost daily basis. However, she often feels powerless to stop it (despite feeling guilty). She feels overshadowed by Kaeleigh and believes her father favors her twin, even if it is in a perverse way. To cope with her traumatic family situation, Raeanne turns to drugs, alcohol, and sex. Meanwhile, Kaeleigh, who bears the weight of her trauma internally, starts to self-harm. She wants to feel alive and like she has some control. To her, self-harm is the only way for her to feel "normal." The novel follows the twin's descent into those worlds and their eventual decision to seek help for their trauma.
However, in a particularly dramatic twist, the novel reveals that Raeanne and Kaeleigh are not separate people; they are two personalities of the same person, Kaeleigh. Kaeleigh's trauma caused her to develop dissociative identity disorder. Raeanne was created as an alternate persona to shoulder the abuse and the associated emotions in an effort to protect Kaeleigh. Although difficult, this ultimately allows for Kaeligh's healing journey to commence.