Consanguineous marriage customary in many societies boosts infant recessive disorders. Proposals to discourage it violate genetic counseling ethics. Custom holds major social value. Bans prove ineffective. Practice aids targeted genetic counseling. Identify high-risk families for carrier testing. British Pakistanis face high thalassaemia from cousin marriages. Inbreeding doubles birth defect risks in studied groups. Pakistan shows elevated beta-thalassaemia via prenatal data. Oman population structure reveals heavy consanguinity. Beirut couples aware of genetic risks yet persist. Community control programs succeed with counseling. Thalassaemia screening reduces affected births long-term. Inbreeding costs include DNA-level variations. Recessive loads higher in inbred offspring. Ethnic groups like Pakistanis need specific guidelines. Norway data links parental consanguinity to defects. UK Pakistani Muslims experience thalassaemia family impacts.