I was thinking about the torture to create multiple personalities and I suspect each of them in the club has an alter/alters.They don't just do this to others, they do it to their own children.
Look at GWB. One of his alters is most likely a prepubescent boy with a crush on Mike. It would also explain the childlike pose in front of his desk playing with planes.
Clinton. The pic of him in the blue dress points to his alter being a very self assured woman. It might also explain Bill's blank look in an old vid.
In addition to these sexual alters there are probably some pretty capable alters for day to day but they probably need someone to prod them now and then (handler).
I'm sure there are other examples but I don't want to speculate too much. It may explain away some of the facial differences as well. Sometimes when a different alter takes over it can change facial expressions, making someone appear older or younger or whatever.