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Cousin Marriage - 70% in Pakistan - Should it be Prohibited?
Hank Pellissier   May 26, 2012   Ethical Technology  

Six Legs? A baby boy - Umar Farooq - was born with six legs in April, 2012, in southeastern Pakistan.  International press noted that the boy’s parents were cousins, a common occurrence in Pakistan, where 70% of the marriage are “consanguineous.” Was the deformity caused by genetically-similar commingling?

Probably not. Polymelia (a rare genetic disease) was suspected at first, but eventually the extra limbs were blamed on an undeveloped “conjoined (Siamese) twin.”  The reasons for conjoining are unknown

Eyebrows were already raised around the world, though. Tongues wagged, netizens clucked. The consequences of “inter-breeding” are generally well-known: offspring from these unions exhibit abnormalities with greater prevalence than average, particularly when the practice is repeated for multiple generations.

What are the deleterious risks of consanguineous mating? Here’s a sampling: schizophrenia, congenital heart defects, pulmonary stenosis and atresia, cystic fibrosis, cystinosis, nephronophthisis, spinal muscular atrophy, albinism, achromatopsia, hearing disorders, central nervous system anomalies, congenital anomalies, physical handicaps, mental retardation and malignancies, added risk of infant and child mortality.

High-Risk Recipe

Statistics on the danger of ingrown genetics were publicized in 2005 when a BBC report claimed Pakistani-Britons produce 33% of the nation’s children with genetic illnesses, even though they account for only 3% of the births. (55% of Pakistani-Britons marry first cousins.) 10% of these newborns either die in infancy, or endure a serious disability. Pakistani-Britons who are first cousins are, claimed the report, 13X more likely to have children with recessive disorders than the general population.

This dire prognosis is duplicated in the US state of Ohio, in Geauga County, where the Amish population represents 12% of the citizenry. After inter-breeding for 300 years, Amish total 50% of the county’s special needs cases. Additionally, there’s a debilitating seizure disorder that’s so rare only twelve individuals worldwide are afflicted with it; the infirmity is exclusively Amish.

A recent book, Consanguinity in Context, by Alan H. Bittles, a medical geneticist at Murdoch University and the Centre for Comparative Genomes in Australia, has dismissed the hazard potential as inconsequential. Bittles claims the rate only elevates from 2-3% to 4-6% if parents are first cousins. A Saudi Arabian report also claims an elevation rise from merely 1.7 to 2.8%, and the London-based Human Genetics Commission claims the risk “rises to about six in every 100 births, i.e. double the risk.” 

Why are these 2X stats so diminutive compared to the 13X greater risk of UK Pakistanis, and the 4X greater risk of the Amish? Why does the Human Genetics Commission state abnormalities of 6%, but BBC indicates 10%? 

Bittles suggests that “environmental” factors elevate the rate of consanguineous birth defects. Another possibility, in my opinion, is that research simply can’t properly calculate increased risk, after centuries of shared genetic material in traditional regions, between cousins who repeatedly inter-marry.

First cousins related via a single channel are obviously far less at risk than those whose ancestors have interwoven DNA for 300 years (the Amish) or 1,300 years (Islam entered Pakistan in 712 AD.) It’s interesting that the Amish elevated rate of risk - 4X - is approximately 1/3 the elevated risk of Pakistanis - 13X - with this ratio near-duplicated again in their length of inter-marriage - 300 yrs / 1300 yrs.

Kissing Cousins Internationally

Worldwide attitudes on cousin marriage differ considerably, with the prevalence - both currently and historically - far greater than Westerners realize.

What nations define it as a no-no? Ethiopia appears the most prohibitive: it bans marriage between relatives out to 6th cousins. South Korea bans out to 3rd cousins; Taiwan and The Philippines ban first cousins, as does China, ever since it’s 1981 Marriage Act. In the USA, 31 of the 50 states ban first cousin marriage. In Europe and South America, consanguinity generally isn’t banned, but it is rarely practiced. Europe’s rate is generally less than 1%, and Brazil’s is presently 1.1%.

Where do cousins marry? Africa, the Middle East, and South Asia are the most consanguineous regions in the world, largely due to its general acceptance, even preference, in Islam. In India, the Muslim rate of cousin marriage is 22%, with the rate nearly doubling to 40% in Jammu and Kashmir. Pakistan, noted earlier, is the world leader in consanguinity with around 70%; Saudi Arabia is 50+%; Iran and Afghanistan are 30-40%, Iraq 33%, Egypt and Turkey 20+%, and Qatar 54%. Subsaharan Africa is estimated between 35-50%, with Nigeria’s opinion split tribally: Hausas prefer cousin marriage, Yorubas condone it; Igbos ban it.

Is the practice climbing or descending in popularity? In Qatar cousin marriage has increased 12-18% since the previous generation; it’s also increased in Morocco, Mauritania, and the Sudan, but it’s declining in Lebanon, Egypt, and Palestine. (These 2009 statistics were compiled by the Dubai-based Centre for Arab Genomic Studies (CAGS), in a research project that also discovered that Arabs have one of the world’s highest rates of genetic disorders, with 66% of the abnormalities linked to cousin marriage.)

Today 1.1 billion people are either married to cousins, or the children of consanguineous unions, and 10.4% of humanity is second cousins, or closer. Why is cousin marriage so popular? It Always Has Been. Robin Fox of Rutgers ventures that, throughout history, approximately 80% of all marriages have been to first or second cousins. In the West, Charles Darwin married his cousin (Emma), so did Edgar Allan Poe (Virgina), Albert Einstein (Elsa), Queen Victoria (Albert), Franklin Delano Roosevelt (Eleanor), and H. G. Wells (Maria).

Reasons and Consequences

In the 19th century, several Rothschilds (the prosperous banking family) intermarried for one of the same reasons as many of today’s Muslims - Keep It In The Family. (I’m referring to the family jewels, double-meaning intended.) Assets accumulated via generations of hard work are deemed more secure if “outsiders” are not allowed matrimonial claims to the goods. Marrying within the family also guarantees that no unusual customs or ideas will waft in to threaten the established patterns, plus family ties are strengthened, negotiations are easier, and it’s harder to hide family secrets from potential in-laws.

Proponents of consanguinity like to boast that their divorce rates are low. Personally, I find these statistics meaningless because cousin marriages are nearly always coercive “arranged marriages.” Does love for one’s spouse keep cousin marriages together?  Probably no more than spontaneous romance brought them together. The force that originally and permanently binds them is family pressure.

In the United States, cousin marriage was acceptable nationwide until an 1846 Massachusetts Commission implicated cousin marriage as a “retardation” factor. Twenty years later, a similar report from Kentucky linked cousin marriage to deafness, blindness, and idiocy. These early analyses were exaggerated, of course, but scientific reports indicate a lowering of IQ in cousin-marrying population groups. For example, in a study of North Indian Muslim schoolchildren the intermarried children’s mean IQ was 88.4, whereas the control group was 99.6.

The mental risk is convincing enough for me to list consanguinity as a hazard factor in two of my previous IEET essays, Brain Damage - 83 ways to stupefy intelligence, and Six Brain Damage Scourges that Cripple IQ in SubSaharan Africa.

With all this evidence stacked against cousin marriage, why does it persist? Don’t political leaders oppose it, or at least seek solutions? Indeed, they are. Instead of banning the practice, though, they recommend genetic counseling and screening. Every Persian Gulf state now requires genetic exams before marriage, with Qatar the last to mandate it, in 2009. Kuwait also established a new law in 2009, prescribing pre-marriage check-ups. Additional high-consanguinity nations that either promote or mandate premarital exams are Egypt, Syria, Tunisia, Morocco, Bahrain, Turkey, Saudi Arabia, Lebanon, Iran, and undoubtedly others.

Western Hypocrites?

Are counseling and exams just a frail bandaid? Are they truly effective? Are they capable of catching all the myriad genetic mines that lie hidden in our DNA? Why don’t governments just ban it? Yes, cousin-marriage is “traditional”, but with every new generation of inter-marriage, it’s dangers are amplified.

Ordinarily, I’d recommend an absolute ban, because I support eugenics that guarantee the maximum health of an arriving child, a position I staked out when I penned last year’s IEET essay, Ban Baby-Making Unless Parents Are Licensed. Obviously, there’s risk in cousin-marriages that can harm new life brought into the world. I believe society has an obligation to guarantee, to the greatest extent, optimal mental and physical health to every newborn. That’s what I want, so why don’t I insist on an absolute ban, right now?

I hesitate… because… I’d be a hypocrite if I adhered to that eugenic stance. The truth is, if there was legislation in my own nation that allowed only unions that were 100% safe, those laws…would have ruined my own family plans. Regard these sentences in Discover Magazine

“…first cousin marriages entail roughly the same increased risk of abnormality that a woman undertakes when she gives birth at 41 rather than at 30. banning cousin marriages makes about as much sense, critics argue, as trying to ban child-rearing by older women.”

Among the “critics” is the Human Genetics Commission

“the effect of increased maternal age on the rate of Down Syndrome… can be compared with the increased risk of consanguinity. At 35 years of age the risk of Down Syndrome is four times that at age 25 and it increases 15 times by the age of 40… [Both] cousin marriage and increased maternal age… represent complex cultural trends…”

Yikes!  My youngest daughter - Zenobia - emerged out of my wife’s 40-year-old womb…

Zenobia also endured added risk due to my contribution, as an Older Dad - I was 51 when she was born. Men that age are guilty, according to studies, of fathering children that have an increased risk of mental illness, “especially autism and schizophrenia” because “the rate of genetic mutations passed on via their sperm cells increases significantly.”

Would I be a fraud, a phony, a total charlatan if I denounced cousin marriage but condoned older parenting? Perhaps, but… my wife and I did pay for amniocentesis, to determine if the fetus had abnormalities. I advocate that this exam and other tech interventions be governmentally paid for via health policies worldwide.

Additionally, I suggest that spunky teenage or early 20’s lads store frozen spoonfuls of their spermatozoa, for procreation use in their later, declining years. I had my sperm analyzed at 50, before I contributed it for conception, and indeed, it had a high percentile of headless and errant split-tail polliwogs, graphically illustrating that my half-century sperm just wasn’t as robust as it was when I was nineteen.

Returning to the question of banning cousin marriage… a prominent Western foe of that notion is Alan Bittles, the Consanguinity in ContextConsanguinity in Context author. He argues, quite logically, that “People with severe disorders like Huntington’s disease, who have a 50 percent chance of passing it on to their offspring, are not barred from marrying because of the risk of genetic defects… so cousins should not be, either.”

His mathematical and ethical reasoning is absolutely right. If governments decide to keep people from reproducing because offspring can be disabled, they need to start with the riskiest couples.

Additional Exasperations

Cousin-marriage, in my opinion, is also undesirable for reasons beyond genetic risk. Culturally, I also deplore the practice because it’s almost always arranged, without romance, between the two passive parties. (Bruce Charlton MD, professor of theoretical medicine at the University of Buckingham, posts this equation on his blog: Cousin marriage = arranged marriage = coercive marriage. I want everyone to enjoy, suffer, and endure the sharp drama and sweet, tawdry thrills of flirtation, seduction and courtship. Cousin marriage springs, overwhelmingly, from societies that repress freedom to love.

The clannishness that cousin marriage supports is also stifling to civic democracy, because family members align themselves with the interests of their in-grown family, instead of allegiance to the state. Libya’s “Arab Spring” revolution featured the nation’s schism into 30 major tribes or family clans, and Somalia’s longtime anarchy is essentially a tribal feud between clan warlords, i.e., family leaders. Isolating family members from the ideas, economics, and genetic components of other clans also devalues political debate and stymies meritocracy due to nepotism and corruption.

But… still… outlawing cousin marriage? Is this necessary? Aren’t government-funded pre-natal and natal examinations enough? No? In the long run, is it best to just toss cousin-mating on the scrap-heap of anthro-history, like trepanning? Are all measures less, just promoting dangerous eugenics?

Note my bracket above around “cousin-mating” - because that’s what we’re actually talking about, not the indirect euphemism, “cousin-marriage.” I have few qualms with cousins marrying-but-not-propagating, co-habitating in legal unions, without children between them - there’s no injury there, no harm to others. If they desire offspring, there’s safe, unrelated sperm or/and safe, unrelated eggs that can be purchased. Legislation in this direction is undoubtedly useless, though - married couples almost always want children genetically linked to themselves. I sympathize, but is it fair to the child if this mixture is debilitating, disfiguring, mentally crippling, and/or lethal? 

Is Change Possible?

Does the half-way solution - genetic testing for cousin couples - actually work? Largely, overwhelmingly, NO. The UK’s National Health Service (NHS) provides genetic counseling to consanguineous couples, but that 13X factor that the BBC reported suggests that the option is generally ignored. Why?

Many, or most, Pakistani-Britons are distrustful of the white establishment’s warnings. Disdain is evident in this posting by “Iftkar” on

“Cousin marriage is common in all Muslim countries… in accordance with the teaching of the Holy Quran…. Children are born with defects whether it is cousin marriage or not. Among migrant Muslim communities the defects are due to many factors. The pressure of moving to a different cultural environment and moving from their families, problems of racism and employment are responsible for the defects during pregnancies. The defects are nothing to do with cousin marriages. The hidden agenda is that British society does not want Muslims to bring their spouses from Muslim countries. A man/woman has the right to marry anybody from anywhere. It is a question of human right and the right given to Muslims by the Holy Quran and the sayings of the Holy Prophet…. There is no hard evidence that married to cousin causes birth defects. Before picking on Pakistanis just remember that Queen and Prince Phillip are third cousins. Glass houses…stone…. it is another witch hunt against Muslim community…”

Another barrier that’s perhaps even more imposing than cultural distrust is found in a a Saudi study that discovered, “90% of couples detected as carriers did not follow the advice they were given and went ahead with their marriages.” Couples aimed at matrimony, it seems, either believe in “fate” or in odds that will favor the health of their family.

So…what is to be done?  Here’s advice:

1. More aggressive education about the hazards of consanguinity
2. Promotion of cultural alternatives
3. Obtain support of the consanguineous culture’s leaders
4. Accelerate advances in pre-natal and diagnostic technology
5. To Guarantee Trust - the warnings, counsels, requirements, and restrictions must be distributed in an egalitarian manner to all cultures, especially to the dominant majority. Couples who are carriers of severe genetic disorders need to make sacrifices first, because their offspring are the most at-risk.

Oldsters like me? If a fair nation wants to mandate against cousin marriage, it’s citizenry of age-50+ wannabe-Dads and age-40+ wannabe-Moms needs to be scrutinized, as well. Storing sperm and eggs when they’re young is a commendable strategy.

Perhaps in the future, children like Zenobia will be conceived and gestated, far more sanely, in test tubes and artificial wombs?

Hank Pellissier serves as IEET Managing Director and is an IEET Affiliate Scholar.


Nature hates monoculture. It’s a regular Tower of Babylon story.

Anyway, as usual, I only have one criteria: consent.

Here’s an interesting twist on the subject: this article has been primarily focused on procreation, but fails to consider marriage without it.

What if the cousins were, or agreed to be, sterile, so that there was no possibility of offspring, but wanted to get married for romantic reasons?

Gee, Pakistan just sentenced a national hero—the guy that helped us find Bin Laden—to 33 years for treason, which no doubt left millions of Pakistanis scratching their heads in confusion (is the Gov’t THAT embarrassed they couldn’t find him themselves?) and everybody else in the world completely confused.

Maybe wildly irrational behavior (like the above, or like Jihadism) is not about widespread undertreatment of “routine” mental illness in poorer countries, but more about serious genetic issues. It is worth considering.

At risk of offending some people, overlaying a consanguinity chart over a US map of red vs blue states might also be instructive. There are some libertarian ideals on the American Right worth considering, but it seems to me that poorer people in “red” states very frequently vote against their own economic interests. This is often ascribed to bigotry or Evangelicalism, but maybe the reasons are less ideological and more biological.

Which of the states permit it?

I am strongly against such kind of negative eugenics. Moreover, I would rather legalize any kind of incestuous marriage as well. What’s at the stake here is not health of society but personal freedom of its members. We need to state it directly and unambiguously: marriage is a private affair of two adult persons. Conscious behavior should be encouraged (education, family planning, genetic counseling etc.) — as we see, the more society is developed, the less pakistanic marriages it has. But not by banning. No one should ever treat people as slaves of their genes, as in more and more countries people are no longer treated as slaves of their gender (in case of same-sex marriages). Instead, people should be treated by default as having enough wisdom to decide themselves whether to take any risks of having their own children or not, and not to be forced by decision of any kind of Nazi-style eugenic commission.

EverYoung - So, you believe “radical personal freedom” trumps every other issue? I don’t - especially, if the consequence is creating lives burdened with disabilities. I believe “personal freedoms” are fine as long as they don’t hurt other people…

your notion of “people should be treated by default as having enough wisdom to decide themselves whether to take any risks of having their own children or not”—is not and has not been successful. Generally, people marrying cousins are deprived of sufficient information, or they distrust the information they are given.

You are right about improving - “Conscious behavior… [via] education, family planning, genetic counseling etc.”

Your argumentation is also rather…. high-strung. Two examples:

1. your statement: “What’s at the stake here is not health of society but personal freedom of its members” - (uh… “health” of society is obviously at stake when the abnormality rate increases 2X -11X, your sentence is inaccurate)

2. Bringing in the “Nazi” reference - an obvious, scare-tactic.

The problem is Hank, who defines “disability”?

From a post-human perspective, every human alive is disabled.

Life itself is nothing more than a contagion, a disease.

If we were to take the argument that consanguineous mating has a probability of genetic defect to it’s absolute, logical end, then we must also conclude that all reproduction has some of this probability as well.

Therefore, we should outright ban reproduction, don’t you think?

Where exactly does one draw the line? Can we put a precise number on it?

Should it be 50% or greater chance gets banned?

Do we need to screen everyone?

How does that work? Who’s going to pay for it?

Prohibition in this case, like most others (drugs, speech, violence) does not work, and is not affordable.

Life is inherently risky, and this includes reproduction and it’s consequences.

On the other hand, I am all for advancing genetic therapy, so that when (for example) two consanguineous individuals reproduce, we can repair any resulting genetic damage in their offspring.

Remember, the Singularity is near.

The kinds of proposals you offer, prohibiting this or that (or requiring parenting licenses) are unfeasible, and in a short time, will become irrelevant.

Our mastery of genetics will become so advanced by the end of this decade, that one will be able to mate with whomever, and the offspring will always be 100% free of all genetic defects.

Sometimes it’s difficult to fully realize all the ramifications of technological advancement.

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