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Nikodemos warns here of the dangers of Adopted or Blood Brotherhood rituals turning into homosexual relationships.

  • Recessive risk need to be managed by improving awareness of it, including the elevated risk associated with marrying relatives such as first cousins where there is a history of marriage within the family, and by ensuring appropriate genetic counselling.

Rather than discouraging consanguineous marriages in populations with long-held such tradition, ensuring access to preconception and premarital counseling services is the logical way to proceed and more likely both to receive community acceptance and be successful in maintaining and improving health Alwan and Modell ; Bittles.

  • Closer consanguineous relationship such as a double first cousins couple may be given a higher risk for their offspring which may be estimated at triple the rate of birth defects in the general population Christianson et al.