LIVING TOGETHER Shaking Off the Shame By SARAH KERSHAW Published: November 25, 2009 MUNCY, Pa. Suzanne DeChillo/The New York Times FAMILY TIES Shane Winters and Kimberly Spring-Winters, first cousins, married this year despite her mother’s concerns. The Laws, State by State Erik S. Lesser for The New York Times TOGETHER Kathy and Dale Hollenbach, first cousins, hardly knew each other until his wife died in 2007 and she sent her condolences. “What I tell everyone is that you don’t choose who you fall in love with,” she said. WHEN Kimberly Spring-Winters told her mother she was in love, she didn’t expect a positive response — and she didn’t get one. “It’s wrong, it’s taboo, nobody does that,” she recalled her mother saying. But shortly after the conversation, Ms. Spring-Winters, 29, decided to marry the man she loved: her first cousin. Shane Winters, 37, whom she now playfully refers to as her “cusband,” proposed to her at a surprise birthday party in front of family and friends, and the two are now trying to have a baby. They are not concerned about genetic defects, Ms. Spring-Winters said, and their fertility doctor told them he saw no problem with having children. The couple — she is a second-grade teacher and he builds furniture — held their wedding last summer on a lake near this tiny town in central Pennsylvania. But their official marriage took place a month earlier in Maryland, at Annapolis City Hall, because marriage between first cousins is illegal in Pennsylvania — and in 24 other states, according to the National Conference of State Legislatures — under laws enacted mostly in the 19th century. While many people have a story about a secret cousin crush or kiss, most Americans find the idea of cousins marrying and having children disturbing or even repulsive. The cartoonish image of hillbilly cousins giving birth to cross-eyed, deformed and mentally disabled children has endured in the national psyche. But even in the United States — one of the few countries in the world where such unions are illegal — marriage between first cousins may be slowly emerging from the shadows. Although it is still a long way from being widely accepted, in recent years cousin marriage has been drawing increased attention, as researchers study the potential health risks to children of cousins. And the couples themselves have begun to connect online, largely through a Web site called Cousincouples.com, which bills itself as “the world’s primary resource for romantic relationships among cousins,” and is trying to build support for overturning laws prohibiting cousin marriage. For the most part, scientists studying the phenomenon worldwide are finding evidence that the risk of birth defects and mortality is less significant than previously thought. A widely disseminated study published in The Journal of Genetic Counseling in 2002 said that the risk of serious genetic defects like spina bifida and cystic fibrosis in the children of first cousins indeed exists but that it is rather small, 1.7 to 2.8 percentage points higher than for children of unrelated parents, who face a 3 to 4 percent risk — or about the equivalent of that in children of women giving birth in their early 40s. The study also said the risk of mortality for children of first cousins was 4.4 percentage points higher. More-recent studies suggest that the risks may be even lower. In September, Alan Bittles, a researcher at the Centre for Comparative Genomics at Murdoch University in Australia and one of the authors of the 2002 study, published a paper in Proceedings of the National Academy of Sciences that reported that the mortality rate was closer to 3.5 percentage points higher. He said he expected ongoing research to find the risk of defects to be lower than previously assumed as well. “It’s never as simple as people make it out to be,” said Dr. Bittles, noting that very early studies did not account for factors like access to prenatal health care, and did not distinguish between couples like Ms. SpringWinters and her husband, the first cousins in a family to marry, and those who are part of groups in which the practice is common over generations and has led to high rates of genetic disorders. “But the widely accepted scare stories — even within academia — and the belief that cousin marriage is inevitably harmful have declined in the face of some of the data we’ve been producing,” he said. Dr. Bittles, who is working on an update of the 2002 study, and other researchers argue that laws against marriage between cousins were rooted in myth and moral objections, and that they amounted to genetic discrimination akin to eugenics or forced sterilization. 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, he said, so cousins should not be, either. Historically, marriage between cousins has been seen as desirable in many parts of the world, and even today, slightly more than 10 percent of marriages worldwide are between people who are second cousins or closer, Dr. Bittles said. In the United States, the percentage is thought to be much smaller, although it is difficult to estimate, since such marriages have long been an underground phenomenon, because of laws forbidding them and because of the lingering incest-related stigma. Martin Ottenheimer, who wrote “Forbidden Relatives: The American Myth of Cousin Marriage,” a 1996 book that was the first detailed examination of the issue in the United States, compared marriage between cousins to same-sex marriage. “People say, ‘If we permit this, what are we permitting? We’re down the slippery slope toward chaos. Then we’ll permit people to marry dogs,’ ” he said in an interview. “The stigma has stuck for so long.” But others who have revisited the 2002 study warn that potential risks should not be downplayed. Diane B. Paul, a professor emerita of political science at the University of Massachusetts, Boston, and a research associate in zoology at Harvard, was an author of a paper published last year in the journal PLoS Biology that described the difficulty of generalizing about the potential for birth defects or increased mortality in the children of cousins. Each couple’s risk depends on the individuals’ particular genetic makeup, she said, which means “it’s very difficult to determine.” And even the small average risk of defects reported in the 2002 study, she added, represents nearly double the risk to children of unrelated parents. That kind of uncertainty doesn’t sit well with many people, including some legislators. Despite the efforts of some in Minnesota and New Hampshire to overturn state laws against cousin marriage after the 2002 study was published, it remains illegal there. And as of 2005, it is against the law in Texas as well. The Texas ban was part of a law targeting polygamy, and the state representative who proposed it, Harvey Hilderbran, a Republican, said he would not have introduced a bill simply to prohibit marriage between cousins. Still, he said in an interview: “Cousins don’t get married just like siblings don’t get married. And when it happens you have a bad result. It’s just not the accepted normal thing.” ALTHOUGH their mothers are sisters who are friendly and live only a halfhour apart, Ms. Spring-Winters and Mr. Winters barely knew each other growing up, because he spent most of his childhood with his paternal grandfather in a town about a half-hour away. The two connected a few years ago, when she was student teaching. Her aunt — who is now also her mother-in-law — suggested that on nights when the weather was bad, she stay with Mr. Winters, who lived closer than she did to her teaching assignment. She began to spend time with him, and the two grew close. “I worried that people thought I was just resorting to my cousin because I couldn’t find anyone else,” Ms. Spring-Winters said. As a religious Methodist, she said, she also worried that marrying her cousin would be wrong in the eyes of her church. But as it turned out, the Methodist Church has no official position on marriage between cousins, unlike the Roman Catholic Church, which requires cousins to obtain dispensation before marrying. And after talking to a relative who is a Baptist minister, Ms. Spring-Winters said, she discovered that the Bible does not say anything explicitly negative about cousin marriage, although it does list examples of sexual impurity, including relations with “close relatives,” like sisters, stepchildren, grandchildren, aunts and stepsisters; and those between mothers and sons, and fathers and daughters. “If the Bible said no, we wouldn’t have done it,” she said. They are somewhat open about being cousins, and have told some friends, Ms. Spring-Winters said, but they don’t tell everyone. Hanging in their home are photographs of each of them at different stages of their lives, from infancy to adulthood, paired in frames, along with pictures of their shared maternal grandparents and Mr. Winters’s 13-yearold son from a previous marriage. One picture of the couple embracing is in a frame with the word “cousins” written over the top and, along the bottom, “the most important thing in life is family.” Ms. Spring-Winters’s mother, Eileen Spring, said that the photograph makes her uncomfortable, and that she has asked her daughter not to display it so prominently. Mrs. Spring, a school nurse, has tried to make peace with herself about the relationship, she said, but it has been a struggle. She has been afraid to tell people about it, and when she has, she said, they have been shocked. Even in a small town in Pennsylvania, she said, it would be easier for her to tell people her daughter was a lesbian. “I knew what people would be saying,” she said. “Nowadays anything goes, but they still don’t like cousins.” She is worried about her future grandchildren, she added, partly because diabetes runs in the family, but also because she fears they will be treated as outcasts or ridiculed by their peers. But when she found out her daughter wanted to marry her cousin, she said, “Even though I was torn, that little voice kept saying, ‘O.K., Eileen, you taught her to be her own person.’ ” For other married cousins, though, family relations have deteriorated irrevocably. One couple living in upstate New York, who spoke on the condition that their full names not be published, knew each other well while they were growing up. They spent holidays together and were regular pen pals. When they were teenagers, they began to acknowledge their romantic feelings, and 16 years ago, when Bob was 20 and his cousin was 18, they married. “I must have asked her to marry me about a million times,” Bob said, but his cousin kept saying that it was wrong and that the family would not approve. She was right. They now have two daughters, 13 and 14, who are in good health, he said, but her parents — his aunt and uncle — refuse to speak to them. Their daughters have never met their maternal grandmother, and they met their maternal grandfather only once, at a funeral. The couple, who live on a military base, have advised their daughters not to tell friends that their parents are cousins. “We don’t typically tell folks,” Bob said. “We told our daughters, ‘It’s not something to be ashamed of, but if you tell your friends, your friends may trust you today, you may be good friends, however, roll the clock forward, people are fickle, and preteens and teens can be downright cruel.’ ” But many cousin couples say they believe the happiness they’ve found together far outweighs the risk of offending other people. Two first cousins, Kathy Rohrer, 52, and Dale Hollenbach, 70, hardly knew each other until a couple of years ago. After Mr. Hollenbach’s wife died in 2007, Ms. Rohrer wrote him a condolence letter, and he visited her at her home near Atlanta. She was married, but was in the process of divorcing, and over the next few months they spent time together. “I was on a cloud nine,” Mr. Hollenbach said. “It’s like Kathy said, we didn’t know each other before, and then you meet somebody and it’s love at first sight.” She was excited but nervous, she said, adding, “He was so much fun to be with, I just kept wishing he wasn’t my cousin.” Then she found the Cousincouples.com site and said she realized “it wasn’t as strange as I originally thought.” Last June, they had a small wedding in Georgia, where marriage between cousins is legal, with a horse-drawn carriage transporting them to and from the chapel. They said they both have adult children who were uncomfortable with the fact that they are cousins, but generally, family members have come around. “What I tell everyone is that you don’t choose who you fall in love with,” said the new Mrs. Hollenbach. “You can deny your feelings, but that leads to being a miserable person who goes through life trying to find a partner just like your cousin. Which will never happen.”