UK health service defends ‘benefits’ of first-cousin marriage

The NHS has argued that such unions offer “stronger extended family support systems and economic advantages”.

UK campaigners and politicians have criticized the National Health Service for promoting the “benefits” of first-cousin marriages, after it compared the genetic risk of cousin marriage to that of having children later in life or smoking and drinking during pregnancy.

The practice has been legal in Britain since the 16th century, when Henry VIII altered kinship rules to marry Anne Boleyn’s cousin, Catherine Howard. Current legislation prohibits unions between parents, children and siblings, but not first cousins.

Conservative MP Richard Holden has tabled a bill to outlaw such marriages, arguing they endanger children’s health. His legislation returned to the Commons last week and is due for a second reading early next year.

In response to calls for reform, NHS England’s Genomics Education Programme published an article last week weighing whether a ban should be introduced. It cited “various potential benefits, including stronger extended family support systems and economic advantages.”

While conceding the higher risk of congenital conditions, the NHS compared it to that of delayed parenthood or smoking and drinking during pregnancy.

Earlier material from a Bradford NHS trust, cited in media reports, suggested that cousin unions – linked to about 30% of local birth defects – were comparable to white women delaying childbirth beyond the age of 34. The document described both decisions as cultural practices shaped by social values.

Holden slammed the publication, saying the “NHS should stop taking the knee to damaging and oppressive cultural practices.” He argued that the Labour government remains “deaf” to demands to outlaw such unions, which he described as a “backdoor to immigration.”

Critics said the guidance undermined awareness efforts. Aisha Ali-Khan, whose three brothers died young from health problems she blames on her parents’ cousin union, told the Daily Mail she does not want “other families to go through what ours did.” Aneeta Prem, who leads the Freedom Charity, called such unions a “safeguarding risk.”

An NHS England spokesman said the article was a “summary of existing research and policy debate,” not an official position, adding that education and genetic counselling would be more effective than prohibition.

Image credit: Sandy Millar