NHS Withdraws Controversial Report on First-Cousin Marriage Amid Backlash

The UK’s National Health Service (NHS) recently found itself at the center of controversy after publishing a report that appeared to highlight “benefits” of first-cousin marriages. The document, titled “Should the UK government ban first-cousin marriage?”, sparked immediate outrage and was subsequently removed from the NHS website. The report, published by the NHS England’s Genomics Education Programme, described potential advantages of cousin marriages, including “stronger extended family support systems and economic advantages.” Critics were quick to point out that the guidance failed to adequately address the well-documented health risks associated with such unions, particularly the increased likelihood of birth defects in children born to first cousins.

First-cousin marriages occur between individuals who share a set of grandparents – specifically, they are the children of siblings. While such marriages remain legal in many countries, including the UK and Australia under the federal Marriage Act 1961, they are increasingly scrutinized by medical professionals due to health concerns. Medical research has consistently shown that the risk of birth defects or disabilities in children born to first cousins is approximately double that of children born to unrelated parents. While unrelated parents face a 2-3% risk of having a child with birth defects, this risk increases to 5-6% when the parents are first cousins. This heightened risk has led to growing calls for legislation against the practice in several countries, including recent bans in Norway and planned restrictions in Sweden, with similar proposals gaining traction in the UK.

In its defense, the NHS initially claimed the article was merely “a summary of existing scientific research and the public policy debate” and not expressing an official NHS viewpoint. The now-deleted document had noted that first-cousin marriages have been legal in the UK since the 1500s, dating back to when King Henry VIII married Catherine Howard, his ex-wife’s cousin. It also contextualized the health risks by comparing them to other pregnancy risk factors like alcohol consumption, smoking, and advanced parental age, noting that “none of these factors are banned in the UK.” However, the presentation of this information was widely criticized for potentially misleading the public, with Dr. Patrick Nash, an expert on religious law and director of the Pharos Foundation, calling the guidance “truly dismaying” and arguing that “cousin marriage is incest, plain and simple.”

The practice of first-cousin marriage presents a complex cultural landscape worldwide. While increasingly taboo in Western countries, it remains common in parts of the Middle East, Africa, and Asia. Globally, it’s estimated that more than 10% of all marriages worldwide occur between first or second cousins, though accurate statistics are difficult to obtain due to stigma surrounding these relationships. In the United States, 24 states currently prohibit first-cousin marriages, with an additional 8 states allowing them only under specific conditions. Connecticut recently joined the states banning such unions, with the prohibition taking effect on October 1st. The debate around this issue extends beyond health concerns, as some cultures that practice and encourage first-cousin relationships have been linked to women’s oppression, adding another dimension to the ethical discussions surrounding these marriages.

The controversy highlights the tension between cultural practices and public health considerations. While the Conservative Party in the UK has proposed legislation to ban cousin marriages due to health concerns, opponents argue that such a ban would be discriminatory and culturally insensitive. Some experts suggest that education about the risks, rather than outright prohibition, might be more effective in addressing what they describe as a “declining trend.” This tension was illustrated by the recent case of a couple from Grimsby in northern England, Faz and Ania, who publicly acknowledged their relationship as first cousins on social media. Their revelation prompted significant online backlash, with many commenters expressing shock and disapproval, describing their relationship as something from “the 1800s.”

The NHS controversy reflects broader societal debates about the balance between personal freedom, cultural traditions, and public health concerns. As scientific understanding of genetic risks advances, many countries are reassessing their positions on cousin marriages. The reaction to the NHS report demonstrates the sensitivity surrounding this issue and the potential for misunderstanding when complex scientific and cultural topics are presented without adequate context. Moving forward, health authorities face the challenge of providing accurate information about genetic risks while respecting cultural diversity and avoiding stigmatization. The incident serves as a reminder of the importance of clear, comprehensive health communication, particularly when addressing practices that intersect with deeply held cultural traditions and personal freedoms.