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When two people wish to perform oral sex on each other, they must align their bodies so that their faces are in contact with the others' genitals. If you envision the numerals 6 and 9 as "people" in which the round portion of the symbol is their head, and the tail of the symbol is the approximate location of the genitals, putting them together as "69" can look somewhat like the position said individuals would take to perform the aforementioned mutual oral sex.
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