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Within the next two decades, numerous reports (e.g., one from the Kentucky Deaf and Dumb Asylum) appeared with similar conclusions: that cousin marriage sometimes resulted in deafness, blindness, and idiocy.Perhaps most important was the report of physician Samuel Merrifield Bemiss for the American Medical Association, which concluded cousin inbreeding does lead to the physical and mental depravation of the offspring".Cousin marriage is an important topic in anthropology and alliance theory.Children of first-cousin marriages may have an increased risk of genetic disorders, particularly if their parents both carry a harmful recessive mutation, but this can only be estimated empirically, and those estimates are likely to be specific to particular populations in specific environments.Cousin marriage has often been chosen to keep cultural values intact, preserve family wealth, maintain geographic proximity, keep tradition, strengthen family ties, and maintain family structure or a closer relationship between the wife and her in-laws.

Opinions and practice vary widely across the world.When a question about cousin marriage was eventually considered in 1871 for the census, according to George Darwin, it was rejected on the grounds that the idle curiosity of philosophers was not to be satisfied.Cousin and sibling marriage were legal in ancient Rome from the Second Punic War (218–201 BC), until it was banned by the Christian emperor Theodosius I in 381 in the West, and until after the death of Justinian (565) in the East, but the proportion of such marriages is not clear.Later studies by George Darwin found results that resemble those estimated today.His father, Charles Darwin, who did marry his first cousin, had initially speculated that cousin marriage might pose serious risks, but perhaps in response to his son's work, these thoughts were omitted from a later version of the book they published.

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