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She argues that the health risks to children born into such partnerships must be addressed like any other public health issue.
The marriage of Neila Butt to her first cousin
Mrs Cryer told Newsnight: "I think the sooner we start to have a debate, we start to encourage the Asian community to address it themselves by saying we have to stop this tradition of first cousin marriages."
British Pakistanis are 13 times more likely to have children with genetic disorders than the general population.
What are your views on this subject? Is Ann Cryer right to call for an end to cousin marriage? Do the cultural and social benefits of cousin marriage outweigh the increased, but still small, risk of having a child with a genetic disorder?
The e-mails published reflect the balance of opinion received.
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Surely if it's wrong, then nature will sort it out via the good old method of "survival of the fittest". If you want to ensure the longevity of your family, then surely it's better to marry outside of the family. The odd first-cousin marriage here and there isn't going to do much damage but over many generations the risks are higher. It seems nature intended us to diversify!
C Bailey, UK
I do not see what the difficulty is in first cousins marrying. In those close families where first cousins have grown up together and know each other very well a degree of compatibility tends to develop. Provided that both cousins consent to marry, there is no harm. What about the all too common situation we have today where people marry and divorce on a whim. Where is the bond? After all, marriage should be for life and thereafter, and not simply for 5 mins.
It's their life so it must be their choice
In Jewish culture it is also acceptable and I think people need to be made aware of any potential risks; the same way Jewish and other ethnic groups are screened for possible genetic diseases before considering parenthood.
Rather than ban first cousin marriages we should look at blood and genetic testing to identify any risks of recessive genes and other inherited diseases. After all, the odds of a couple from the general population both having the same recessive gene is still an issue, if a lower risk than with close relatives.
Incest is illegal in most societies. Is first cousin marriage so different? If not, what about aunts and uncles, second cousins or forth cousins twice removed? Where do we draw the line: We are all related if we go back far enough.
While I have some sympathy with Mrs Cryer on this issue, banning is not the answer. We should start with education, not coercion.
Brian Fileman, Otley
At the risk of stating the obvious, the risks cited are due to cousins having children, not cousins marrying. A child doesn't automatically appear after marriage, and forbidding marriage doesn't suddenly make people sterile. Surely it'd make sense to direct any response (be it an educational campaign, legislation or whatever) at the issue itself?
Alexander Whiteside, Canterbury
I personally think getting married to your first cousin is not a good idea, not that there is a risk of high illnesses but because they are like your brothers/sisters! But all my cousins so far got married to their first cousins and nothing has happened so far.
Aliyah Ahmed, Manchester
As a GP to the Bradford Asian community for many years it is important to recognise that the effect of first cousin consanguinity is to produce lethal combinations of recessive genes which have the effect over a few generations of removing these genes from the gene pool. Whether this justifies the misery created in the process is a judgement that must be made by those affected. However it also must be recognised that this practice actually strengthens the gene pool rather than weakens it!
Dr Michael Ross, Keighley
This kind of marriage is a human phenomenon, which I believe also has some roots in British royal history, and we should not single out any one ethnic community. Why not counsel and screen couples to make sure offspring will be safe from any inbred disorders?
I am a British Pakistani and have always shied away from the idea of first cousin marriages due to the genetic element. However, I got very protective and angry when I read comments from Hindus on this page jumping on the bandwagon to condemn it. Before making silly comments on how seriously ill children of cousin marriages should be refused state medical help, realise that we all come from different cultural backgrounds.
Robina Rayasat, Birmingham
If a substance was found that caused such devastating effects it would be banned. If an employer was found to expose its workers to a substance which could have such an effect he would be prosecuted. It's about time practices like this were outlawed, not only for the sake of the children who are born affected by this practice but to reduce the burden on society having to cope with it.
I think the show really brought home the message from one point of view about the effects of continuous cousin marriages within the family. However, what about just a one-off cousin marriage brought about by love, pure and simple? The facts and figures were quite blurry and so entangled in opinion that it was hard to take an objective view to the situation. The best thing is to obviously marry outside the family, however if this is not at all possible for whatever reason then simply a genetic test should be taken by each person. This will highlight the risks involved and make them aware. If people still do not take this on board than at the end of the day it is the choice of the individual and who are we to judge? Yes, this is a great strain on the NHS but can also adversely affect actual lives as we saw in the film. But the same can be said for sexual promiscuity, so then should we start putting a ban on the number of partners people sleep with?
As a doctor working in clinical genetics, I would like to make two points. Firstly, the risk for any couple of having a child with a serious medical problem is about 2-3%. The risk for first cousins is about 5-6% - that's 2-3% more than the rest of the population (as long as there is no history of a known recessive condition in the family). This additional risk decreases sharply with the distance of the relationship (e.g. much less for second cousins, etc.). Secondly, there is NO genetic test for "compatibility". There are thousands of recessive conditions, for many of which the gene is not known and no test is available.
Ellen Thomas, London
The statistics, and conclusions reached by Ann Cryer are suspect. She is making a huge leap of faith here - attributing the increased risk of birth defects to cousin marriages. Her conclusion is baseless and in error. In 2002, the National Society of Genetic Counsellors found that first cousins have an increased risk of only 1.7% to 2.8% of having a child with a birth defect. No couple has a zero chance of having a child with a birth defect. Cousin marriages should not be legislated in my opinion. I married my first cousin 10 years ago. We have a perfectly normal, healthy relationship. I am amazed that such misinformation is still getting into print.
Keith T, NC, USA
Here in Israel there has for several years been a well-funded health initiative to teach Israeli Arabs about the dangers of first cousin marriages. Unfortunately, Israeli Arabs had for many years a stubbornly higher neo-natal mortality rate due almost solely to the genetic problems that manifest due to widespread practice of first cousin marriages. In the last few years there have been fewer first cousin marriages, and genetic disorders have been falling rapidly amongst Arab-Israelis. The neo-natal death rate amongst Arab citizens has also fallen dramatically.
Why is it suddenly so wrong? Cousins are free to marry each other by Islamic law. It is patronising to be told now who one should and should not marry. Also, it is insulting to argue that these parents don't care about their kids. As to the forced marriage debate, let's not throw all Asian marriage issues together as if they are all connected.
There is no need to ban cousin marriage if you follow Gore Vidal's famous logic on creationism. He said that if all the creationist leaning states were allowed to teach creationism freely, they would be reduced to primitive cultures in about two generations. The same is true of any relationship that produces unhealthy offspring. The ethical question of the misery this causes the offspring is a separate issue from whether people should be prevented from marrying who they wish. My grandparents were first cousins and although I now happily hold them entirely responsible for all my genetic failings - I do owe them my existence and I think this rather balances the equation out.
Colin McLean-Campbell, Ulm, Germany
In a world where there are "anonymous adoptions", "sperm donors", "egg donors", "cloning" and "tissue donors", we may all end up not just marrying cousins but siblings without even knowing it. I think medical testing should be freely available to couples prior to marriage to spot potential genetic problems. But this does not even begin to tackle all the babies born outside of marriage.
The problem is NOT first cousin marriage, but the custom of continuing the practice through the generations. The key to solving the problem lies in education of the risks and empowering individuals to make their own decisions. The statement that Ann Cryer wants the practice "outlawed" suggests to me that Cryer is a crass politician with little understanding of her role within the community.
I would like to clarify the points regarding Islam and Culture. The Prophet Muhammed PBUH advised the Muslims that it is permissible to marry from within the family, but it is preferable to marry from outside the family due to medical conditions. Today we need to differentiate between "forced and illegal" and "consenting and legal" marriages. The Prophet Muhammed PBUH told the people that for a marriage to take place both the male and female have to give their consent, and to force either one is something abhorrent and illegal in Islam (though rejecting a good Islamic spouse is extremely disliked within the religion). One also needs to remember that marriage the western way is to have relationships prior to marriage until the "ideal" partner is found. With the average age of marriage rising, rising divorce rates and growing numbers of single parents, this idea is clearly a failed concept, one which actually contradicts Christian doctrine of no sex before marriage. By replacing God's laws with man-made ones, one cannot expect "harmonious godly" outcomes! Please also remember the British monarchy was based on marriage to cousins, thus the concept is not localised to the Pakistani community.
Abu Musa, Lancaster
My paternal grandparents were first cousins, and I have often wondered if that might have something to do with my suffering from two rare disorders. But my grandparents had five healthy children, and there was nothing wrong with my older siblings either, so perhaps I have just been unlucky! Until reading this article I had not even considered the possibility of successive cousin marriages. Whether or not cousin marriage is legal, I am extremely concerned to hear now of it being practised by successive generations! That should not be permitted to happen any more. If that means enlarging incest laws to apply to first cousins, then so be it.
Geoff Digby, Wellington, New Zealand
It never ceases to amaze me how many people who contribute to these forums don't read the story properly before writing. Ann Cryer has stated that she is not calling for a ban on cousin marriages. What she has said is that she wants people to be aware of the risks involved and for a debate. Where is the harm in that?
Peter Gaunt, London
Marrying with cousins may cause birth defects. However, it is surprising to see an outcry from a society where divorce rates are over 50% and taking alcohol is common among women. Both these things probably cause more psychological an physiological problems in children.
This is very common among Muslims, despite a saying of the prophet who once saw weak boys sitting under a tree and asked who are these weaklings, he was told that they come from a people who marry their relatives. My parents are first cousins, and my siblings have rare genetic diseases that have disabled them severely for life. My parents are aware of that saying from the prophet, but like many Muslims they ignored it and now they are paying the price.
Once again Mrs Cryer has gone to an extreme. Yes, we need an open debate on the issue, but to force people to "adopt" a certain lifestyle based upon personal opinion or to score points with a small number of her constituents is wrong. Marriage between cousins is part of the lifestyle choice of many of her constituents, although I myself don't intend to marry a first cousin. Better understanding of the advantages and disadvantages of the issue is what we need, not further alienation.
Ashraf Khan, Keighley
Mrs Cryer says, "as we address problems of smoking, drinking, obesity, we say it's a public health issue". Now, how many of these things are illegal? What are their associated diseases and death rates? All I want to say is lets not go nuts here.
Mustafa, Toronto, Canada
The acceptance of first cousin marriage probably depends on such marriages being a relatively rare event. A single generation with slightly less genetic drift in a family tree that is otherwise sufficiently diverse will present a far lower risk of genetic abnormality than if "first-cousin marriage" is a common event in a given family tree. I believe that forming a sexual relationship with a person whom you can trace on your family tree is probably not wise but forming a sexual relationship with a person whom you can trace on your family tree several times via different routes is irresponsible.
John Wiseman, Maidstone
Cousin marriages are not forced in Islam but have been inherited in Pakistan as an Indian sub-continental tradition. Islam actually discourages first cousin marriages in favour of casting the net wider and building bridges with the wider Islamic community regardless of race or colour. It is in fact "makruh" which in Arabic means reprehensible although not "haram" which would be illegal. Mrs Cryer may want to expend her energies elsewhere too. What will happen to the offspring of the children of the few sperm donors in the UK who may not know if they are copulating with biological half-siblings, and what of the children who are adopted with no record of their biological ancestry kept, and what of the children of mothers who do not even remember the child's father? Cousin marriages are not recommended and greater education is required. Islam has the solution to all the dilemmas of modern society if we actually look at the scriptures rather than the practices of the wayward colonised masses.
Omar Ali, Jeddah/UK
I think the point is being missed in this debate, seemingly because people misunderstand the unique nature of cousin marriages in CERTAIN Pakistani communities. It is not the odd person marrying their cousin that is the problem, it is the obsession with recursive cousin marriage that occurs within a family for generations that causes the most damage.
Surayya Khan, London
It is rather simplistic to call for an end to the cousin marriage tradition. Although I am not part of the Asian community, I do recognise the importance that such marriages have in their social and cultural framework. Rather than condemning the ancestral practices of a whole community, resources should be invested into genetic testing facilities at local hospitals and education programmes.
E Iwheta, London
Presumably, the medical side effects of marrying close relatives such as a cousin have been known for a long time, probably centuries, in many countries. So it is not a new thing. A harsh and sad life, though, for the children of such a union who are afflicted with medical problems. What is the real reason for this practice? Could it be that it is marrying someone that is known and feeling comfortable with or could it be for other reasons, e.g. financial? Certain types of marriage are not acceptable on religious and/or legal grounds. If marriage of cousins was to be made illegal, then it would logically need the support of the major religions. Medical evidence may well indicate the practice as undesirable, but it would require careful handling to outlaw it if some people are likely to claim they are being discriminated against. In this country, the vast majority of people want to choose their marriage partner. It could be argued that they are not free to choose if marriage to a cousin is not permitted. If the marriage is a forced one, then that is a different story.
Anthony C Seaman, Southwick
As part of Britishness, all engaged couples should be subjected to marriage banns. Have we gone so far down the road of political correctness that we've forgotten about "consanguinity", "affinity" and/or "spiritual relationships" that have traditionally nullified marriages in this country? Society has thrown out the baby with the bathwater.
Brian McCarthy, Penrith
Rather than legislate against cousin marriages, we should have a proper campaign of information amongst communities about the medical risks of such unions. Until families start to ask the question: "So, what are the risks with such a marriage?" the problem will remain.
Alex H, London
I think that there should be an end to cousin marriage! No matter how small the risk of your child being born with a genetic disorder it should absolutely outweigh the cultural and social benefits of cousin marriage! I myself am not Pakistani so I cannot relate to the cultural side of this argument, but having a healthy baby is what British Pakistanis should be focusing on.
Rakhee Vadher, Birmingham
People should be free to adopt whatever culture they like, as long as others don't have to pay, literally, for the consequences (such as through taxation). This, in my view, is what should determine whether the government should prohibit this practice or not.
I have been living with my girlfriend for almost five years. She is my cousin. After both suffering painful divorces, following many years of marriage, we now share extraordinary true love, happiness and friendship with each other. I could not imagine a world without her. We both have wonderful children from our previous marriages and will not be having any more - this is not just because we are first cousins, more that we are happy with what we've got already! I do hope that we will marry in the near future. How dare Mrs Cryer suggest that we should not be able to do so when the law has permitted such for centuries - and at a time when gay "same sex" couples are now to be allowed to "tie the knot" - not that I have a problem with this either. What else will Mrs Cryer want to ban in the future in order to create her "perfect human race"?
Personally, I believe that it may be quite right that the Pakistani community is in denial about this topic and if this trend is to continue, they will become prone to other diseases, inevitably resulting in far more serious consequences. Though this "tradition" has been within these communities for very long periods of time so it is in their own interest to assess the potential risks, and after all, it is not illegal yet.
Martyn Chapman, Fleet
Marriage with first (or second) cousins is irresponsible because of the high rate of adverse health effects (hereditary disease, mental retardation) in children, and it is one step removed from incest. It should be illegal.
James, Helena, Montana
I used to work on children's wards in Halifax and it's true that children were born with genetic problems. Also, as children got older they had learning difficulties. I don't totally disagree with the marriages but time has moved on and we should all be allowed to marry who we wish. If the marriages are to continue then they should not be allowed to marry relations of any kind.
I think it's disgusting! It should be outlawed - people married cousins 200 years ago but that doesn't mean it's "culteral".
Dale Brown, Birmingham
Within the Hindu customs and traditions, the chances of inter-marriages amongst the cousins is avoided by the use of comparing the birth charts and, in addition, to ensure that the boy and the girl are not of the same "gotra". Gotra is the family tree hierarchy, which goes back centuries. Whereas in the Western culture a Smith marrying a Smith is not uncommon, within a Hindu culture one will rarely find a boy and a girl have the same family names. Of course, I cannot speak of the Muslim community but I have heard that this practice is quite common.
Praveen Thanki, Solihull
Cousin marriage existed at the beginning of the history of humanity. Europeans used to do it. Many Royal family members in Europe marry their cousins. The MP is right to address the health issue, but banning them is wrong. You can encourage people not to have cousin marriage, but it is not a crime so don't waste our resources to enforce such law. With education, you can send other messages like safe sex, AIDS and parenthood issues. It is one stone to kill many birds. Wasting resources to make and enforce such a law is stupid.
Ka-lok Kan, Gillingham
It is a disgusting practise still in vogue in the Indian sub-continent and should be banned. Parsis in India marry among themselves to keep the family fortunes intact, and this inbreeding has caused frequent cases of dementia and other genetic disorders. Hindus also marry their first cousins. Whether a male marrying his mother's brother's daughter is safer than two sisters' children marrying is doubtful. My uncle married his cousin and HIS son in turn married his maternal cousin; luckily they are all well, but how fit will the future generations be?
Having a marriage where in-laws can talk about shared moments may be fine, but I ask how emotionally gratifying is it when your child has a serious illness for the rest of their life? Carry on by all means if you want, but there should be a law that denies state sponsored health facilities to offspring of such relationships. Let the penalty for taking the risk be known.
Vishnoo Rath, Kolkata, India
My grandparents were first cousins from Victorian rural Nottinghamshire stock. So it happens in the indigenous population, too. My father's generation all had successful lives and three of the four are still alive and in, or approaching, their 90s, my uncle having died at 92 and my father nearing his 95th birthday. So, no problems here. Maybe they concentrated useful genes! Our generation hasn't done badly either.
I think marrying a second or third cousin is OK. I wouldn't personally choose it but at least the gene pool has widened a bit more from second cousin onwards. First cousin marriage is too close, though.
There is a better way to deal with the issue of recessive gene disorders - genetic counselling. First, the man and woman are tested for recessive genes. Then, if both are found to carry the same recessive gene, they receive counselling as to the probable effects on an, as yet not conceived, child. This system is being used very successfully in Sardinia where beta thalassemia has been endemic. The combination of education and genetic counselling is more likely to be accepted quickly as it does not challenge traditional culture.
Peter Gans, Leeds
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