• Health secretary calls the advice ‘shocking,’ says such unions are ‘high-risk and unsafe’
• MP Iqbal Mohamed defends such marriages as culturally significant, urges genetic screening over bans
LONDON: Britain’s National Health Service (NHS) has found itself at the centre of a political and cultural row after a government-backed education programme published — and then quietly removed — online guidance describing the potential benefits of first-cousin marriage.
UK Health Secretary Wes Streeting called the advice “shocking” and demanded an apology, saying first-cousin marriages are “high-risk and unsafe.” MP Iqbal Mohamed, however, defended such unions as culturally significant for many families.
Speaking in the Commons, he acknowledged health risks but said many families see such unions as positive for building bonds and financial security, urging genetic screening instead of a ban.
The document, published by NHS England’s Genomics Education Programme last week, stated that consanguineous unions can bring “stronger extended family support systems and economic advantages” even as it acknowledged the increased risk of certain genetic conditions among children of related parents.
Tory MP Richard Holden, who has proposed legislation to ban cousin marriages, condemned the document, calling on the NHS to “stop taking the knee to damaging and oppressive cultural practices.” Holden also linked cousin marriage to immigration and women’s rights, saying the practice “should be ended for good.”
By Monday September 29, the guidance appeared to have been taken down from the NHS website.
New YouGov research shows that three quarters of Britons (77 per cent) say first cousin marriage should not be legal, with only 9pc thinking the law should remain as it is. Prohibiting first cousin marriage is popular across the main parties, with 76-77pc of Labour, Lib Dem and Tory voters opposed to the practice, as well as 82pc of Reform UK voters.
The study
The Genomics Education Programme which is run by Health Education England aims to improve the “genetic literacy” of healthcare professionals and the public. Its 22 September blog post titled “Should the UK Government Ban First-Cousin Marriage?”, stressed that while children of first cousins do face a higher risk of certain inherited disorders, the increase is small and should be tackled through education and voluntary screening rather than bans.
The document emphasised that first-cousin marriage remains legal in the UK under the Marriage Act 1949 and that the government has “no current plans” to change this.
It noted that while the risk of a child being born with a genetic condition rises from about 2–3pc in the general population to 4–6pc for children of first cousins, “most children of first cousins are healthy.”
The guidance also cited research from Bradford suggesting that “endogamy” (marrying within a tight-knit community) may be a more significant factor in genetic risk than cousin marriage itself.
It further warned that stigmatising the practice can deter couples from seeking help, with the British Society for Genetic Medicine instead advocating premarital genomic testing, targeted education and voluntary counselling as more effective ways to reduce risk.
In February this year, a BBC investigation showed how cousin marriage plays out on the ground. Its reporting from Bradford, which is home to one of the UK’s largest Pakistani communities found that first-cousin marriage remains “fairly common” but is slowly declining.
The Born in Bradford study, tracking over 13,000 children, found that about one in six had parents who were first cousins. Researchers found that children of first cousins were more likely to have speech and language problems (11pc versus 7pc for unrelated parents); that they were less likely to reach a government benchmark for “good development” at age five (54pc versus 64pc); and they visited primary care doctors more frequently i.e. about four times a year on average compared to three for unrelated-parent children.
Professor Sam Oddie of Bradford Teaching Hospitals told the BBC “I’ve seen fatal skin conditions, fatal brain conditions, fatal muscle conditions”.
He said such conditions were notably more common in Bradford, recalling families who lost several children to the same genetic disorder — “deeply upsetting and hard to comprehend.”
But the same BBC story underscores that many health professionals, including Prof Oddie, argue it is “an oversimplification” to blame cousin marriage alone. Endogamy, not just direct blood ties, can cluster genetic variants.
Endogamy is not unique to Pakistani communities in the UK. It is an issue too in the UK’s Jewish community and globally among the Amish and also French Canadians.
Prof Oddie said it’s simplistic to blame cousin marriage alone, noting that shared genes within close communities — or endogamy — play a major role in inherited disorders.
BBC interviews found more young women choosing “love marriages” as education and social exposure grow, with cousin marriages among Pakistani-origin mothers in Bradford falling from 40pc to 27pc in a decade.
Published in Dawn, October 5th, 2025
