Kissing Cousins 

The NHS, more used to providing us with rich seams of comedic material than anything vaguely related to health, has struck again, albeit briefly. On an NHS sponsored blog some joker was given free rein to write a posting titled: “Should the UK government ban first-cousin marriage?” Instead of the swift and obvious answer ‘yes’, the blog provided justification for first-cousin marriage.

Sure, there were risks associated with it, but hey, just think of all that ‘community cohesion’ it brings to those who practice it. It strengthens family bonds and is a long practiced tradition amongst certain communities. If it has such virtues and leads to such strengthening of family bonds, why not go all the way and advocate marriage between siblings? After all, that would only be logical.

Don’t bother following the link above, the blog was quickly taken down. Wes Streeting, the next Labour leader in waiting – who may not have to wait long – even demanded an apology for the blog going up in the first place. The identity of the blogger is unknown, but I strongly suspect that the blogger was Pakistani and male.

After all, it is amongst the Pakistani diaspora that first-cousin marriage is routinely practiced and, by a long way, most prominent. I reckon the blogger was male because males in the Pakistani ‘community’ have most to gain from this arrangement.

“Seen anything you fancy, son? From among your cousins, of course.”

Once selected, the poor lass has little choice. The marriage is ‘arranged’ (a euphemism for ‘forced’) and before she knows it, she is being humped by Muhammad, Abdul or Ali when only a few years earlier they had been playing tig in the backyard. Only someone with a vested interest in perpetuating the unacceptable would have the motivation to put up a blog posting advocating first-cousin marriage. If I am wrong, we will never know. But if I am right, then we have slipped into a hellish pit of virtue-signalling.

What business the blogger thought the NHS had to make any comment on family bonds and community cohesion when there is a genuine health message to convey is almost beyond belief. But, again, refer to the point about vested interest above. In any case, the rapidly growing Pakistani diaspora, growing through an influx of young men of military age with radical Islamic views, is the last community amongst which anyone should be advocating cohesion and bonding.

The risks of first-cousin marriage are often exaggerated amongst the general population. The thought that it leads per se to the birth of deformed or mentally subnormal children is wrong. Cousin marriage, by dint of the fact that first-cousins share 12.5% of the same DNA, are more likely than two unrelated people who, in theory, share no DNA to bring together recessive genes. Recessive genes are one that are not expressed unless two copies come together. Some recessive genes are harmless such as the one for blue eyes. But others are not, leading to birth and developmental defects.

A classic example of a harmful recessive gene is the one for the blood disorder haemophilia – also referred to in the past, insensitively, as ‘bleeders’ disease – whereby sufferers who have inherited the genes from both parents lack a blood clotting factor and, therefore, bleed profusely if cut and bruise very easily. The disease was, at one time, prominent in the Royal family due to their propensity towards first-cousin marriage.

But, while there is still often some degree of relationship between royal spouses, they managed to breed haemophilia out of the line of succession. And the results are obvious. Can there be a better example of a functional, well-adjusted and intellectually brilliant bunch than the present British Royal Family? I rest my case…well, almost.

Having established that the risks of genetic disorders are low – but greater – at 4-6% for first cousins compared with 2-3% for the general population, this is essentially irrelevant to the Pakistani population. First-cousin marriage is not just a random, once in a generation event amongst the Pakistani community. In Bradford alone 46% of marriages amongst Pakistanis were cousin marriages and a great many more had some degree of relationship.

The problem arises because first-cousin marriage proceeds down the generations and, with each generation, the risk of inherited genetic defects increases due to repeated first-cousin marriage. The likelihood of genetic defects is cumulative, as shown here (Figure generated using ChatGPT):

I have seen the effect of the above graph with my own eyes while conducting clinical assessments of Omani nursing students in Muscat. While in a medical ward in the UK you might expect to see a patient with sickle cell anaemia once in the bluest of moons, the medical wards at the Sultan Qaboos hospital were full of people with this painful and life-shortening condition.

The local tutors were aware of what the underlying cause was: generation upon generation of first-cousin marriage. With all the permutations down the generations, I even heard of one woman being married to a man who was both her cousin and her uncle (yes, that is possible). I guess the ‘cousin’ aspect trumps the ‘uncle’ aspect.

Contrary to common misconception, first-cousin marriage is not illegal in the UK. The Church of England sets no impediments but, in the Roman Catholic Church, the permission of a bishop is required. The Catholic Church is more lenient in some areas of the world where first-cousin marriage is more acceptable and – marriage being more acceptable than a lifetime of masturbation (admittedly not the only option), it also accedes in situations where choices of a life partner are limited.

But first-cousin marriage is rare outside the Pakistani diaspora and other Muslim countries where it remains common. At around 1% it poses little threat and one case I am aware of within the Catholic Church – where permission is not automatic – was a marriage between an older couple whose spouses had both died and who had encountered each other late in life. Such a marriage has no issue – literally.

Judaism sees no impediment to first-cousin marriage, which used to be more common among Jews but is less so now – especially amongst the Ashkenazi Jews. In other closed Jewish communities it is more common, but precise figures are not available. Some Muslim countries have seen the light and banned first-cousin marriage, e.g. Azerbaijan and Tajikistan. Other places such as Bahrain, Iran, Qatar and the UAE have introduced mandatory genetic screening for cousins planning to get married.

This seems to emphasise the arranged nature of marriages in these places, where romantic love seems to play no part. It also suggests that an industry in genetic testing exists as uncles and aunts have their children genetically tested, and then get together to share the results until they find a couple of cousins for whom marriage is deemed safe.

To many, the concept of first-cousin marriage is repulsive and it comes as a surprise that it is so widely permitted in law and by different faiths. But surely, the time has come, especially in the UK, to see a complete blanket ban on marriage – indeed, sexual relationships – between first cousins. We are seeing an increase in the growth of one community in our midst in which the results of first-cousin marriage are obvious. This represents an increasing burden on our NHS and on the national purse, all among a group of immigrants among whom unemployment and benefit seeking is higher than in others.

Any defence of first-cousin marriage as cultural heritage or community cohesion, collapses under the weight of evidence regarding the harms. While occasional cousin marriages in open populations may not present major dangers, the systematic perpetuation of the practice down generations produces undeniable health risks, a growing burden on health services, and a social pattern that entrenches disadvantage rather than alleviating it. At a time when integration should be a priority, the UK cannot afford to continue tolerating a practice that is medically unsound, socially corrosive, and ultimately indefensible.

Roger Watson is a retired academic, editor and writer. He writes regularly for a range of conservative journals including The Salisbury Review and The European Conservative. He has travelled and worked extensively in the Far East and the Middle East. He lives in Kingston upon Hull, UK.

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