The National Health Service (NHS) staff have received guidance from a government-funded monitoring body advising them not to discourage first cousin marriages in a blanket manner.
According to the National Child Mortality Database (NCMD), healthcare professionals were instructed that it is “unacceptable to discourage close relative marriages in a blanket way.” The guidance emphasizes that parents who are first cousins are only at a slightly increased risk of having a child with a genetic disorder.
Instead of deterring such unions, the document advises that genetic counsellors should meet with couples to provide balanced, non-directive advice. Counsellors are encouraged to discuss genetic risks and guide families on “how to consider arranging future marriages outside of the family,” rather than stigmatizing existing practices.
As reported by The Telegraph, the guidance states: “Action at community level may help people to understand and act on [our] advice; but this is only acceptable if information is balanced, non-stigmatising and non-directive.”
The recently issued guidelines have triggered public debate, with some critics calling for a formal investigation into the NHS’s position.
Previously, the NHS faced scrutiny over guidance that was perceived to suggest potential benefits of first cousin marriages. That document was later withdrawn following widespread criticism from parents, medical professionals, and scientific communities.
In the United Kingdom, first cousin marriage remains legal and is relatively common within certain communities, including parts of the British-Pakistani population. However, many medical experts caution that such marriages increase the likelihood of inherited genetic conditions and serious health complications in children.
Medical research generally highlights increased genetic risks associated with consanguineous marriages. Studies suggest that children born to first cousin couples face a higher probability of inheriting recessive genetic disorders.
A study conducted in Bradford found that children from first cousin marriages were more likely to experience speech and language difficulties and had a higher risk of developmental delays. The research indicated that only 54 percent of these children reached a “good stage of development.”
Data analysis cited by The Telegraph reported that 73 infants under one year of age either died or suffered serious health conditions linked to parental consanguinity, representing approximately 3.7 percent of child deaths reviewed.
In the general population, the risk of having a child with a serious birth defect or genetic disorder is estimated at around 2–3 percent. For first cousin couples, that risk increases to approximately 4–7 percent.
The issue has also drawn political attention. Conservative MP Richard Holden introduced a private member’s bill seeking to ban first cousin marriages, arguing that many associated tragedies could be prevented.
“Behind every one of these deaths is a number of preventable human tragedies,” Holden said.
However, the UK government has shown no indication of supporting an outright ban, instead favoring a policy focused on genetic counselling and informed decision-making.
Shadow Justice Secretary Robert Jenrick pointed out that Norway banned first cousin marriages in 2025, while Sweden is set to implement a similar ban in 2027. He also noted that cousin marriage is prohibited in most US states, calling for the UK to consider aligning with those policies.
As debate continues, health authorities face increasing pressure to balance cultural sensitivity with public health concerns and scientific evidence.
