Nice Incest

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Authored by Dr Roger Henderson, Reviewed by Dr Adrian Bonsall | Last edited 27 Jul 2016 | Meets Patient’s editorial guidelines
This article is for Medical Professionals
Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find one of our health articles more useful.

Treatment of almost all medical conditions has been affected by the COVID-19 pandemic. NICE has issued rapid update guidelines in relation to many of these. This guidance is changing frequently. Please visit https://www.nice.org.uk/covid-19 to see if there is temporary guidance issued by NICE in relation to the management of this condition, which may vary from the information given below.
Incest can be defined as sexual activity with a person from within the immediate family. However, the exact relationships which can be construed as incest will vary from culture to culture. Many countries have laws that forbid incest but there is considerable variation in the exact nature of these.
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In England and Wales the Sexual Offences Act 2003 created an offence of familial sexual abuse (this is covered in Scotland in the 2009 Sexual Offences Act, and in Northern Ireland in the Sexual Offences Order 2008). The aim of this law was to protect children up to the age of 18 from any form of activity that a person would consider sexual or indecent. The offender may be an adult or another child. It recognises the modern family unit and it defines familial sexual abuse as being between a person and their parent (including adoptive or foster), grandparent, child, grandchild, sibling or half-sibling, uncle, aunt, nephew or niece[1].
The Sexual Offences Act 2003 also prohibits adult sexual relationships but within a slightly narrower definition that includes just close blood relationships only - parent, grandparent, child, grandchild, brother, sister, half-brother, half-sister, uncle, aunt, nephew or niece.
The most common manifestations are sibling incest and father-daughter incest[2].
Sibling sexual abuse is usually recognised as being the most common form of sexual abuse within families. It has been documented as being five times more common than father/stepfather abuse[2]. Father-daughter incest was reported by 2.5% of female participants in an anonymous computer-assisted self interview[3]. One study from Scandinavia looked at all child sexual abuse in one area[4]:
The offender is reported as male in most cases but female involvement may be under-reported. Although sibling incest is thought to be the most frequently occurring form of incest, the abuse of daughters by fathers or stepfathers is more commonly reported[5]. Abuse by stepfathers is up to five times higher than that by biological fathers. Physical symptoms may include:
Incest is usually repeated and will often continue for many years. As the daughter reaches an age when she may be able to resist or flee, the activity may be repeated with a younger sister. Though the profiles of incestuous families may vary, the father-perpetrator is typically an immature individual with low self-esteem, while the wife-mother is depressed, helpless or otherwise emotionally absent[6]. The father often uses alcohol to allay his inhibitions before molesting his daughters. Theories have proposed that girls may feel powerless to take active steps to end the abuse for fear of disrupting the family unit[7].
The increase in the divorce rates may have placed more children at risk than previously. When women begin new relationships, they may unwittingly be putting their children at greater risk for sexual abuse from the men they date. The study by Stroebel et al identified risk factors for father-daughter incest[3]. In the study, father figures were included within the definition of father-daughter. These risk factors included:
According to another survey, if the mother remarries, "the stepdaughters are over eight times more at risk of sexual abuse by the stepfathers who reared them than are daughters reared by their biological fathers"[8].
See the separate Safeguarding Children - Referral and Management of an Abused or At-risk Child article for details as the principles of management are the same.
The child's welfare is paramount. The child's best interests override other considerations such as confidentiality, consent and the carer's interests.
Where there is an immediate risk of serious harm to a child, act immediately.
Share information with other agencies on a "need to know" basis.
Where possible, and if compatible with the child's best interests:
Respect the child's views.
Obtain consent.
Involve the carers (if the child is competent, this must be with the child's agreement). Do not involve carers if this would compromise the child's safety or evidence.
Keep full and contemporaneous records.
Remember other children in the household - are they at risk?
All doctors have a duty to safeguard children and to ensure follow-on care for the child:
The non-specialist's role is not to make a definite diagnosis of child abuse but to recognise the possibility and enlist appropriate help.
The doctor concerned about a child must ensure follow-on care.
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Krienert JL, Walsh JA; Sibling sexual abuse: an empirical analysis of offender, victim, and event characteristics in National Incident-Based Reporting System (NIBRS) data, 2000-2007. J Child Sex Abus. 2011 Jul-Aug20(4):353-72. doi: 10.1080/10538712.2011.588190.
Stroebel SS, Kuo SY, O'Keefe SL, et al; Risk Factors for Father-Daughter Incest: Data From an Anonymous Computerized Survey. Sex Abuse. 2013 Jan 29.
Carlstedt A, Forsman A, Soderstrom H; Sexual child abuse in a defined Swedish area 1993-97: a population-based survey. Arch Sex Behav. 2001 Oct30(5):483-93.
Cyr M, Wright J, McDuff P, et al; Intrafamilial sexual abuse: brother-sister incest does not differ from father-daughter and stepfather-stepdaughter incest. Child Abuse Negl. 2002 Sep26(9):957-73.
Kutz I; Revisiting the lot of the first incestuous family: the biblical origins of shifting the blame on to female family members. BMJ. 2005 Dec 24331(7531):1507-8.
Herman JL; Father-daughter incest, Boston. Harvard University Press, 2000.
Russell DEH; The secret trauma. Incest in the lives of girls and women. Rev Ed, New York: Basic Books, 1999
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A Reddit user asked people who had willingly engaged in incest to share their stories in an anonymous form and stories came flooding in. 
People were quick to share their unique experiences and if their lives had changed because of them. Some people looked back on their past fondly while others admitted to the years of healing they needed to get over their stories. 
“My wife's family has multigenerational incest, to the point that she only has three sets of great grandparents.
There are no signs of problems in their generation, and they all married way outside the family tree.”
Story credit: Reddit / @throwafession
“In the Netherlands we have a saying that goes: 'neef en nicht het neukt allicht'. It means something like: 'cousins, [they love each other]'. Back to the matter at hand: might be an unpopular opinion but it seems as though what you guys have is totally legit. It isn't culture-wise but if this isn't love, I don't know what is.”
“My cousin and I kissed and had very obvious crushes on each other when we were little (like, 6 or 7). Eventually we grew out of it, but we were always close. We were even roommates in college. But that didn't end super well and right now, we're kind of resentful of each other.”
Story credit: Reddit / @ACE-Shellshocked
“I'm pretty sure my sister and dad had an incestuous relationship. They were obsessed with each other, she was like his house pet. She never had a relationship or a job, she just lived in the condo he bought her and got fat. She died two years ago and he still keeps her place the same as it was.”
Story credit: Reddit / @my_family_secrets
“My cousin and I have been in an ongoing relationship for over 20 years now. Her father and my Mom are brother and sister. This all started when we were 12 years old. We lived a few miles apart growing up, so we knew each other since we were babies. We began fooling around at about 12 years old. 
We both recently came out to our spouses and told them both about our relationship with each other. Both of our spouses were very upset, and we totally understood. My cousin’s husband left and my wife and I are heading on that path. My cousin and I look like we are going to be with each other. I honestly feel bad for what happened to our married relationship, but I think that it is for the better. My cousin and I are madly in love, and our passion for each other is still like day one.”
Story credit: Reddit / @CuzWBenefits
“My cousin and I, she's a 22 y/o girl, I'm a 26 y/o guy, started texting (she's had a crush on me since we were tiny, I didn't think she was attractive until she was around 18, but she clearly has liked me for as long as we've been alive). The texting quickly escalated to flirting. When we met face to face the next time at a family thing, she was with her boyfriend but totally ignored him and was all over me, it was a little awkward because we were clearly digging each other but it seemed like her boyfriend could tell. I’ll admit that the whole "taboo factor" has definitely made us more into it.”
“Okay so 2 years ago-ish, my best friend hooked me up with her friend who was in a lot of my classes so I knew her a bit well since I basically knew everyone. We all were planning a double date basically, and that was in like 2 weeks.
The three of us hung out numerous times and she'd always try to hold my hand or come onto me. I always jerked away because it always felt weird and I had no idea why, I just figured its because Im awkward and never really been in a relationship.
This kept going and I just decided to end it because I wasn't comfortable.
A week later she's taking pictures of my other cousin on my dad's side who I don't know that well because he kind of abandoned my mom and I and is in and out of jail all the time.
Turns out, she knew the whole time we were cousins and thought I knew too. I guess my weird instincts were right. Welcome to Indiana.”
“I met this guy on Tinder, we started dating, had sex a couple times. I was on Facebook and my actual first cousin who I know well had uploaded a picture with two of our other cousins and Tinder guy with the caption "cousins <3".
I freaked out at this point and called my mom to ask her if she knows who is in the picture with my cousins. Turns out he is my mom's half brother's son. My mom and her half-siblings don't get along and even though I knew they existed I never knew who they were.”
“From the moment we met, my half sister and I were absolutely in love at first sight. We had a long, wonderful, secret relationship with each other for about 10 years. But, taboo is a powerful force, and nearly getting caught forced us apart.
She's with someone and has been for a long time now. I've been married for about that long too. Many people comment on how much my wife and her boyfriend resemble my sister and me, respectively.
I still think about it sometimes. I miss her terribly.”
Story credit: Reddit / @factsmakeyoumad
“Well it happened not too long ago, it started at the beginning of the year actually. She's only a year older than me (20) and she was visiting from the Netherlands. I had only met her once before and that was many years ago. I actually didn't even know she was my cousin until we met again this year. But she was staying over my house for about 2 months and one night me her and my brother and his girlfriend all go out to this bar. Me and my cousin got really drunk and ended up getting back home at like 2am. We had a guest room which is where she was sleeping and I had followed her downstairs for reasons that I don't remember. But the way it started was very innocent. Just touching and staring. But then she gave me a kiss on the lips and it started to escalate more and more from there until we finally just had sex. It was a lot of fun and I really don't regret any of it.”
Story credit: Reddit / @TheGodsKing
“[A] while ago, I was dating someone. As much as she wanted it, I was hesitant about taking that extra step (for reasons that will become apparent in the next story). Later, I'm talking to her mom who I thought was a family friend. Turns out, she (the mom) is my third cousin and I was pajama pants away from giving it to my niece. So that's the fun story I tell around drinks.”
Story credit: Reddit / @throwaway256761
“Well it started when we were 4. We're cousins btw It started because my grandma had left the tv on and we saw some adult situations which made us curious. Well shortly after that started my dad caught us and though we were young enough to not know what we did was wrong, we realized we got in enough trouble to realize we clearly did something wrong. Sometime later I ended up in therapy and am much better now but it totally wrecked my childhood and every family gathering.”
Story credit: Reddit / @CatPatronus
“I'm in a long-term relationship with my biological half-sister on my mother's side. I'm a male.
We didn't grow up together; we actually didn't meet until we were both almost thirty. Never knew each other at all until that point.
I had been trying to get in touch with her on and off for a decade or more, in a desire to meet the long-lost sibling and try to connect as family. I finally succeeded via online social networks and a bit of social engineering. We talked, purely online, on-and-off for about six months with some mostly-unacknowledged sexual tension making us both very uncomfortable. When we did finally acknowledge it, it came together very quickly and very powerfully. At the time, we were both in serious relationships; I was in a non-monogamous relationship and she was actually engaged and fully monogamous. My S/O knew all the details was 100% okay with it; her fiancé obviously had no idea. We agreed to meet up; we had a week of incredible sex and an insanely intense emotional connection equaled by no other relationship in my life, romantic or otherwise. It was a heady week.
Not long after that, we both ended our contemporary relationships (surprisingly mostly-amicably on her end; blood and fire on my end. No, I will not be telling that story.), I moved to be with her and we've going good ever since.
This is a true story, and I've attempted not to editorialize. This relationship is absolutely illegal where we live, and a VERY select few people know about it.”
Story credit: Reddit / @cestceptioncest
“Well... my father is my mother's first cousin (my two grandfathers are brothers). I think I came out fairly normal. A bit socially awkward and with some weird tendencies but nothing medicine and a shrink can't fix. So I guess it's a win in the end.”
“My cousin is married to her other cousin. They both had children from previous relationships and actually had one together. I never knew he was my cousins cousin until this year actually. I was pretty shocked. I remember going to their wedding when I was 15. I was told that they did know they were cousins but they didn't grow up together. He lived in England she in N.I. She had a child with an abusive man previously. She is really happy now with him (her cousin) and I’m happy for them.”
Story credit: Reddit / @Alexandriaiona
“My family lives far apart so we have a family reunion every 3 years. My family isn't the most athletic, attractive or socially skilled family but very intelligent people. Me(17) and my cousin(16) don't really fit into our family's stereotype and we're the youngest so we'd always hangout at these family reunions. Last reunion down in Florida everyone went up from the beach and it was just me and her left. We skinny dipped and ended up making out. Not sure how it's gonna be next family reunion.”
Story credit: Reddit / @NinjaWithACokE
“Two of my mum's cousins were together for the best part of a decade (didn't marry), they had kids/grandkids from previous marriages and they were a totally normal couple who regularly babysat their grandkids etc. I never once thought it was odd and neither did my parents.”
Story credit: Reddit / @cowboyslayer
“My cousin and I in our early/mid teens got drunk one night and we kissed. I groped her chest over here clothing. That is as far as it went. Next day we sobered up and we apologized profusely to each other. Nothing ever happened again.”
“First cousin. But I didn't know she was my cous
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Nice Incest