Why the NHS is Being Urged to Retract Its Cousin Marriage Guide

The NHS is facing intense pressure to withdraw a document from its Genomics Education Programme that has been fiercely criticised by campaigners for allegedly downplaying the health risks and highlighting the "benefits" of marriages between first cousins. The publication, which campaigners have branded "woke" and "harmful," has ignited a fresh debate over the sensitive issue of consanguineous marriage in the UK.

The controversial document acknowledges the established evidence that first-cousin marriage—a practice common in certain communities, particularly British Pakistani—is linked to an increased likelihood of a child being born with a genetic condition or congenital anomaly. However, the document also lists purported benefits, such as 'stronger extended family support systems,' and claims that a ban would 'stigmatise certain communities.'

This stance has drawn immediate condemnation from individuals with lived experience and anti-abuse charities. Aisha Ali-Khan, whose Pakistan-born first-cousin parents tragically lost three children to serious health difficulties that she believes were linked to their consanguineous union, has called for the immediate withdrawal of the guidance. "For the NHS to say that cousin marriage is something which has been going on for centuries just undermines what those of us with lived experience have been saying," she told the Daily Mail. She argued the document is "wrong" and its publication is a setback for those working within communities to discourage the practice due to health concerns.

Aneeta Prem MBE, founder of the Freedom Charity, also weighed in, criticising the guidance as a failure to acknowledge safeguarding risks. "First cousin marriage is not just a cultural tradition – it is a safeguarding risk," she stated, linking the practice to "dishonour abuse" where young people may be pressured into the unions.

The NHS document attempts to contextualise the risk by noting that other factors, such as parental age over 34, smoking, and alcohol use, also increase the chance of congenital issues and are not banned in the UK. It suggests that instead of prohibition, the focus should be on 'genetic counselling, awareness-raising initiatives and public health campaigns.'

This comes after a previous controversy where an NHS trust in Bradford—an area where studies have suggested cousin marriage accounts for approximately 30 per cent of birth defects—likened the decision to marry a first cousin to 'liberal values' causing white women to start families later in life.

The political response remains cautious. Despite Tory MP Richard Holden introducing a bill to ban first-cousin marriages, Downing Street has previously indicated the Government has "no current plans to change the law," opting instead for education and support measures.

The British Society for Genetic Medicine (BSGM) has historically warned that a ban on cousin marriage is not justified on health grounds alone and risks stigmatising communities, undermining trust, and causing couples to disengage from vital clinical support. They, like many experts, advocate for premarital genomic testing and genetic counselling to empower couples with informed choices.

In an official statement, an NHS England spokesman sought to distance the main body from the document, clarifying that the article published on the Genomics Education Programme website is a 'summary of existing scientific research and the public policy debate,' and is "not expressing an NHS view." However, campaigners argue that its publication under an NHS banner lends legitimacy to a practice that carries significant and preventable health risks. The calls for a definitive retraction and a shift in official messaging are likely to intensify.