The NHS has come under intense criticism after publishing guidance that highlighted potential benefits of first-cousin marriage, despite the well-documented health risks associated with the practice.
The guidance, released through NHS England’s Genomics Education Programme, described first-cousin unions as offering “stronger extended family support systems and economic advantages.” Critics, however, argue this framing ignores the significant dangers of genetic disorders in children born to closely related parents.
Health and Social Risks Highlighted
Marrying a first cousin is legal in the UK, but it substantially increases the risk of genetic conditions such as sickle cell disease and cystic fibrosis. Campaigners also point to wider concerns, saying the practice can reinforce oppressive cultural structures that restrict women’s freedoms.
Richard Holden, a Conservative MP, called on the NHS to withdraw the material, stating: “Our NHS should stop taking the knee to damaging and oppressive cultural practices. This is a health issue and a cultural issue—cousin marriage must not be legitimised.”
Expert Reaction to NHS Position
Dr Patrick Nash, director of the Pharos Foundation in Oxford, labelled the NHS guidance “truly dismaying.” He argued that cousin marriage amounts to “incest, plain and simple” and called for an outright ban. Nash added that the article misleads the public and should be retracted with an apology.
NHS Response
In its defence, NHS England clarified that the article was not an official endorsement but rather a summary of existing research and debate. The document also noted that first-cousin marriage has been legal in the UK since the 1500s and that other lifestyle factors—such as alcohol, smoking, and parental age—also increase genetic risks but are not banned.
The guidance suggested that genetic counselling and public awareness campaigns should help families make informed decisions “without stigmatising certain communities.”
