In a startling episode of bureaucratic overreach, the British National Health Service (NHS) quietly
removed a controversial guidance document extolling supposed “benefits” of first-cousin marriage, from “stronger extended family support systems” to “economic advantages.”
The document barely saw the light of day before public outcry forced its withdrawal.
However, the deeper issue remains: a publicly funded health institution considering normalizing consanguineous marriage based on cultural sensitivity is concerning.
It’s a warning sign that the U.K. is quickly losing its grip on both medical ethics and science.
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Let’s be clear. Marrying one’s first cousin is a known risk factor for recessive genetic disorders.
The document itself admits that, in the general population, a child has about a 2%-3% chance of being born with a genetic condition, and that risk increases to 4%-6% if the parents are first cousins.
In other words, the odds double, although most children of first cousins are unlikely to have such a genetic condition.
Consanguineous, or cousin, marriages are rare in Western and European countries, accounting for less than 0.5% of marriages.
In North African and Arab nations, consanguineous marriages range from 25% to 55%. Social, cultural, and demographic factors
influence this variation.
Genetic risks are
based on Mendelian inheritance, something we learned in high school biology. Family members share recessive genes that are much more likely to manifest in consanguineous marriages compared to unions of unrelated individuals.
These elevated genetic risks manifest in conditions like cystic fibrosis, sickle cell disease, thalassemia, congenital heart defects, hemophilia A, metabolic disorders, and others. The chain of inherited recessive mutations is subtle but real, and each generation of consanguineous pairing increases the likelihood.
Any policy from a health authority that downplays or ignores those dangers is betraying its ethical duty to “first, do no harm.”
Has the science suddenly changed to justify these new recommendations? Or has cultural and political correctness replaced sound science?
The NHS guidance, now rescinded, was troubling in its original framing as it appealed to cultural acceptance and the social benefits of close-kin support networks. Those arguments are familiar in multicultural policy debates -- you’re not allowed to condemn a practice if it is cherished by communities, or you risk being accused of cultural imperialism, racism, or other -isms.
Yet, the proper way to handle cultural practices that pose health risks is not to endorse them. Instead, it is to educate, regulate, and, when necessary, prohibit.
Historically, cultures have justified practices now widely condemned — cannibalism, slavery, genital mutilation, stoning. Medical authorities are not promoting or excusing such practices. The notable exception is genital mutilation, now euphemistically called “gender affirming care,” which is
endorsed by health authorities.
When a medical system promotes a biologically hazardous tradition as socially beneficial, it shows culture overtaking science in the worst way.
Why should we fund medical research as a path forward when health institutions prefer to revert to dangerous practices from centuries ago?
Did the NHS actually ban cousin marriage? No.
The U.K. has not banned first-cousin marriage. It remains legally allowed, as it has been for centuries. The controversy focused on whether the government (through the NHS) should recommend or promote it, or even consider banning it.
The guidance document questioned whether the U.K. government should ban consanguineous marriage, but that question itself went too far for political and public acceptance.
So far, there has been no legislative effort to prohibit it, only vocal criticism and sternly worded letters from MPs and the media.
If we acknowledge their reasoning, the NHS initially suggested normalization but reversed course after facing backlash. However, they never proposed a binding ban. That’s a half-hearted step, and a risky one. It’s a half-measure for spineless politicians and bureaucrats to dodge taking a stand that might upset some people or cost them votes.
This is similar to decriminalizing behavior, a “don’t ask, don’t tell” nonposition, straddling the line between legalizing and criminalizing.
When elected officials and the agencies they fund and oversee can’t make clear decisions, efficiency and accountability suffer, leaving countries like the U.S. with $37 trillion in debt and at least five times that amount in unfunded liabilities.
How does the U.S. handle cousin marriage? In contrast to the U.K., the United States has a patchwork of laws based on states' rights. Many states ban first-cousin marriage, others allow it under certain conditions, and some permit it outright.
- As of 2025, 24 states prohibit first-cousin marriage altogether.
- 18 states allow it outright.
- 8 states allow it under certain conditions (age limits, infertility, requirement of genetic counseling, etc.).
In 2024, Tennessee passed a ban on first-cousin marriage. More recently, Connecticut enacted a similar law. That move would align Connecticut with the majority of states that already prohibit the practice.
So, the American landscape isn’t uniform, but the trend leans toward restriction or condition rather than embracing normalization. Federalism allows for such diversity, as seen with abortion. This is how federalism should function.
For the U.K., is this cultural suicide or medical recklessness? It seems the NHS’s initial impulse to condone and excuse consanguineous marriage was a self-inflicted cultural wound. It signals deference over duty, moral relativism over medical clarity.
When a society promotes cultural practices that harm genetic health, it reveals a lack of confidence in its culture. They stop believing in the importance of reason, science, and the common good. This is how a society loses strength and collapses.
We can accept multicultural traditions, but only as long as they do not cause harm to future generations. Once a tradition poses a known risk to innocent children, it should be regulated or banned, not promoted. This applies not only to cousin marriage but also to transgender surgery on minors.
The NHS’s retreat under pressure shows that even progressive elites understand that the optics of normalizing “cousin marriage with benefits” are indefensible. But it is not enough to drop the memo; they must completely overturn the underlying assumption.
Here are some suggestions:
1. Commission an independent medical review of consanguineous marriage risks and produce a public report, with transparency and hard science.
2. Mandate genetic counseling for all couples who are first cousins before they can acquire a marriage license.
3. Prohibit state agencies and health authorities from framing consanguineous marriage as culturally beneficial in any official guidance.
4. Consider a legislative ban, or at least a phased prohibition for new marriages, as other jurisdictions have done.
5. Educate communities in vulnerable populations (where consanguineous marriage is more common) with respectful outreach and solid science.
If a government agency discusses “benefits” of a practice that doubles a child’s risk of genetic disease, that agency has forsaken its role as a protector of public health. And if society applauds that surrender, then yes, it can correctly be called cultural suicide.
Britain’s future depends on reaffirming reason rather than relativism and prioritizing children's health over political correctness. The U.S. should follow suit regarding gender transitions, which are a biological impossibility, since both represent distortions of science driven by ideology.
The NHS’s mistake should be a wake-up call.
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