To be disturbed by wilfull ignorance around genetic inbreeding?

[M9009]

I've come from a country were cousin marriage and indeed marriage to any close relative if illegal.
I've recently started working in a dialysis unit and I'm so disturbed by how many parents are young children born of first cousin marriage. Usually from South Asian backgrounds.
Today I was speaking to one parents who has 9 children, all in need of kidney transplants. The eldest 2 have already had theirs. Parents are first degree cousins and each have various medical problems of their own.
Why, as a society, do we allow these marriages? It seems so cruel to the children who are born with medical and genetic problems.
Maybe I'm easily shocked, I don't know.

Any child born with limiting health needs or low survival rates is a tragedy but it’s worrying and depressing when issues are highlighted specifically to other specific groups; a minority of Asians marry within families and these increase the risk of certain conditions but are not the sole cause of them. This area is more complex than the knee jerk prompts such as “people are afraid of being called racist” propaganda implies —genetic education has been going on for years in high risk areas and the risks are not simply due to close relation marriage. It’s frustrating and immature when people want to pile on groups; if people want to look at the strains on the NHS—what about all the alcohol drinkers, obese people, smokers, etc? It’s so easy to deliberately pick an issue that can be serviced to pile on a specific group.
https://www.bbc.co.uk/news/articles/c241pn09qqjo.amp

“…crucially, Prof Oddie thinks the main risk to genetic health in Bradford is not cousin marriage, but a similar issue known as endogamy, in which people marry members of their close community. In a tight-knit ethnic group, people are more likely to share common ancestors and genes - whether or not they are first cousins, he says.
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.
"It's often the case that the exact familial tie can't be traced, but the gene occurs more commonly within a certain group, and for that reason, both parents carry the affected gene," Prof Oddie says. "It's an oversimplification to say that cousin marriage is the root of all excess recessive disorders in Bradford or in Pakistani communities. Endogamy is an important feature."
The Royal family has a good dose of Endogamy too.
If we’re concerned about infant mortality and quality of life — let’s address deprivation:
https://stateofchildhealth.rcpch.ac.uk/evidence/mortality/infant-mortality/

• Social inequalities continue to have a marked impact on infant mortality. The risk of infant death increases with greater levels of maternal deprivation, reflecting the social gradient that exists across underlying risk factors such as preterm delivery, maternal health during pregnancy and uptake of recommended practices such as breastfeeding and safe infant sleeping positions. Infant mortality trends also show widening health inequalities, since 2010 there has been a rise in rates for the poorest children, compared to falling rates for more advantaged infants.7,5,8

My wife is White British has two sets of family members under 80 who were cousin marriages within my fairly immediate family eg aunts uncles and cousins(one is an inlaw). Once I mentioned it and it turns out there is more within the extended family, and often people tell me about theres in response. I think its potentially more common here in Scotland, but in general its probably just not something that gets mentioned

I'm also aware of how common it is for travellers

It would be hard to accurately trace and identify cousins. Her mum was one of 8, her dad one of 6, and subsequently discovered two other siblings that were adopted out. There are cousins that shes never met etc so if you asked her to do a family tree she would struggle struggle!

Cousins can also be a vague term. I call people cousins (common in my culture) that aren't first cousins in the normal sense, but that's simply not the definition of cousin in my culture, biology isnt tracked in the same way, to the extent my medical records include things about an auntie who isn't bio linked to me.

I'm aware that some countries map out your family tree before marriage, but I genuinely dont know how you'd be able to prove people were cousins without dna checking everyone, especially of people are coming from countries with poor records

Even if the info is accurate you dont need to be legally married to have kids and lots of cultures aren't overly worried about legal marriages over ceremonies

You are absolutely right. It's a dog whistle topic. That doesn't mean theres no cause for concern at all but this has been overly focused on in the media for a reason.
A change to the law would be a complete vote winning gimmick that achieves nothing but making some very racist groups feel validated in their 'concern'

There are a lot of initiatives going on but you may not see them. GPs in some cities are talking to families about it.

Bradford City Council have this leaflethttps://www.bradford.gov.uk/media/4097/w36205-cousin-marriage-leaflet-final-082417.pdf

It will take generations but there is work going on to support Asian families to understand the risks.

Thanks for your incisive summary.

Nice leaflet, but as kidney disease is so endemic in the asian genome, the likelihood of it happening remains statistically higher in spite of this advice.

My dm used to work in a London borough school with a unit for children with hearing issues and majority had parents who were cousins

It’s a fact that in populations where consanguineous marriage is practised (1st cousins) with 1 in 6 children born to 1st cousins about 30% of babies are born with a disability and also there is a 25% rate of infant mortality.

this is an avoidable tragedy, as far as the latter statistic.

Go and look at:
https://borninbradford.nhs.uk/our-impacts/findings/genes-and-health-inheritance-and-risk/
for more information.
Better education is a must.

That’s so weird, aside from the obviously bad medical implications, why would the NHS get involved otherwise in advising people who to marry from a social perspective?

Because it's costing them an absolute fortune having to care for all the children with disabilities.

So much so that they feel the need to intervene and try and educate those with the risks is inbreeding.

From the medical journal Pulse

People of South Asian (Pakistani, Kashmiri, Indian, Bangladeshi, among others) origin living in the UK are up to five times more likely to experience kidney failure than the general population.1
While the role of diabetes and hypertension in this population is well known, less attention has been paid to genetic conditions that may underlie or exacerbate renal disease in this group.

So there it is, sad but true

I had no idea it wasn't illegal. Given the serious health implications.

It's very wrong : Pakistani/Irish Traveller etc, it's no excuse

There aren't serious health implications to marriage.
There are serious health implications to family members repeatedly reproducing with each other across generations.
Making cousin marriage illegal wont tackle that. Do you think people have to be legally married to have children?

Pakistanis and Irish Travellers in the UK tend to be socially conservative so if it were illegal they would probs try to marry covertly (maybe relogioysly?) but not have kids out of wedlock altogether.

Time to do some more outcrossing?
It worked for Dalmatians.

Here is a tragic documentary made a few years back...

https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.youtube.com/watch%3Fv%3DVdnWiL99qSw&ved=2ahUKEwi65fGZvqqSAxX0XUEAHc-3AcsQFnoECDoQAQ&usg=AOvVaw3aZjb3NMzRcP6TPhKjMdAh

It is now, it very much did not use to be.

I agree. It's like the circumcision thread I did earlier this month where most of the posters were calling for Jewish & Muslim parents who circumcise to be jailed for child abuse.

I disagree with both and support a cousin marriage ban but not automatic child removal.

I'm sure you're right. It's the wider implications that have people getting all preposterously precious about the issue.

There's a simple(-ish) solution. If you're in a risk group, get genetically tested. When pregnant also genetically test the embryo(s). Have an abortion if there's genetic problem. If that's not something you can do, then prevent those couples from having non-adoptive children.

But that alternative, even though rational, would probably be considered even ruder than a blanket ban. Given the current atmosphere of making as many baroque conflicts as possible where there really aren't any.

It wasn't fully gone : Jane Austen characters marry first cousins (Fanny Price in Mansfield Park in early 1800s , for one). Austen's own brother Henry married their first cousin Eliza.

And of course Queen Victoria is a good example of why first cousin marriage is a bad idea...

I agree it was not common though.

No. You missed my point. I was asking why the NHS would have been advising people in favour of it from a social perspective.

That was what the original comment had referred to, that the NHS had previously been encouraging it from a social ties and support perspective. I was curious why the NHS would have any involvement in the social aspect of peoples marriages. I would understand why they would advise against it from a medical perspective.

Well Muslims, esp conservative rural Pakistanis, generally object to abortion on the grounds of disability..

Irish Travellers I think tend to be Catholic so would also do that?

How would you ban cousin cohabitation, though?

Agreed. The financial cost is already huge, and will only get larger. So many children are being born in the UK with terrible disabilities due to their parents and grandparents and great grandparents all being cousins. Hence the gene pool is tiny and rare genetic conditions become commonplace.

This is a wholly avoidable tragedy.

Education and offering genetic testing has failed. Anyone still suggesting this is the solution is a fool or a coward or both

Many parents who are cousins, and have a very disabled child, ignore medical advice or even blame the doctors. So they cruelly and selfishly have more children with the same genetic condition.

We need to urgently legislate to:

• Ban marriages between 1st or 2nd cousins
• Require all religious marriages to include or be preceded by a civil (legal) marriage

The UK Government could do both this year as part of its Wedding Law Reform Bill to widen the type of venues where a marriage can take place.

I very much fear it won't as Labour is cravenly focused on winning the next election. It hopes this will help shore up its 'Muslim vote'. It won't.

Traditional Labour areas with large Muslim populations will elect Gaza-focused Independent candidates regardless in 2029. This is a battle Labour has already lost, but it remains stuck in denial. It keeps wasting more and more political capital in pursuit of a wholly lost cause. Sunk cost fallacy in action. Farage must be delighted by Starmer's cowardice and his lack of political nous.

We saw this in the 2024 general election with the first time election of:

• Adnan Hussain, Independent MP for Blackburn
• Ayoub Khan, Independent MP for Birmingham Perry Bar
• Iqbal Mohamed, Independent MP for Dewsbury and Batley
• Shockat Adam, Independent for Leicester South

Iqbal Mohamed has already spoken in Parliament to defend cousin marriage, and prevent legislation banning it.
https://news.sky.com/story/mp-speaks-out-against-proposal-to-ban-first-cousin-marriages-13271018

I'm beginning to feel both growing contempt and bewildered disbelief for this Government. It has no moral compass or courage left. It is willing for thousands of severely disabled children to be born because it (wrongly) hopes looking the other way and not taking action might mean they'll win the next election.

What is the point of them now?