Many consumers turn to mail-order DNA testing companies (such as 23andMe) to learn about their ancestry—an increasingly popular practice.

This has implications not only for those who have been affected by incest, but also for the clinicians who treat the physical and mental scars left behind.

 

The prevalence of incest

 

Solid numbers on the prevalence of incest are hard to come by due to the stigma attached to it and the difficulty in getting people to talk about it.

The rise of consumer DNA testing services has proved that incest is not just a one-in-a-million kind of thing. According to a recent article in The Atlantic, unpublished research from UK Biobank (a large, anonymized research database) showed 1 in every 7,000 participants was born to parents who were first-degree relatives—either siblings, or a parent and a child.

DNA tests are uncovering the true prevalence of incest. The Atlantic. March 18, 2024.

 

Considering that not all cases of incest will result in pregnancy, the true prevalence of incest is likely even higher.

 

Mental and physical impacts

 

Unfortunately, research on incest and its effects has been stifled in recent decades, a phenomenon a psychiatrist writing in Psychiatric Times suggests could be related to a movement starting in the early 1990s accusing therapists of suggesting abuse that hadn’t actually occurred.

Ramifications of incest. Psychiatric Times. January 12, 2011.

 

 

 

The Rape, Abuse & Incest National Network (RAINN), the largest anti-sexual violence organization in the US, lists a host of health problems that can impact people who have experienced sexual violence, including incest.

Effects of sexual violence. RAINN. June 3, 2024.

These include depression, flashbacks, self-harm, STIs, substance abuse, dissociation, panic attacks, eating disorders, unwanted pregnancies, sleep disorders, and suicide.

 

Survivors may also suffer from post-traumatic stress disorder, which in turn has been linked to sexual dysfunction, particularly among military veterans and survivors of childhood sexual abuse.

 

Another organization, Incest AWARE, lists additional health issues that can arise following incest, such as lingering feelings of being alone or unloved, low self-esteem, and chronic physical pain or illness, among others.

What are the effects of incest? Incest AWARE. June 3, 2024.

 

 

 

Preventing 'accidental incest'

 

The greater prevalence of incest also raises concerns about “inadvertent consanguineous conception,”

Practice Committee of the American Society for Reproductive Medicine and the Practice Committee for the Society for Assisted Reproductive Technology. Guidance regarding gamete and embryo donation. Fertil Steril. 2021;115(6):1395-1410.

or accidental incest, that can occur when two individuals conceived using sperm from the same donor later have a child together.

 

Fertility clinics generally limit the number of times a donor’s sperm can be used to mitigate this worry, and the issue is also addressed in current guidelines on gamete and embryo donation from the American Society for Reproductive Medicine.

Practice Committee of the American Society for Reproductive Medicine and the Practice Committee for the Society for Assisted Reproductive Technology. Guidance regarding gamete and embryo donation. Fertil Steril. 2021;115(6):1395-1410.

The group recommends maintaining sufficient records to set a limit on the number of pregnancies that can be achieved with a given donor’s sperm, with considerations for the population and geographic area the donor comes from.

 

 

Treatment for those affected

 

Treatments are, fortunately, available to help anyone who has been harmed by incest. Authors publishing in Innovations in Clinical Neuroscience reviewed psychotherapy options for survivors of sexual abuse and assault in general, but this would apply to those with a history of incest as well.

Cowan A, Ashai A, Gentile JP. Psychotherapy with survivors of sexual abuse and assault. Innov Clin Neurosci. 2020;17(1-3):22-26.

Evidence-based treatments include psychodynamic psychotherapy, trauma-focused cognitive behavioral therapy, and eye movement desensitization and reprocessing therapy.

 

 

Processing abuse and trauma is a helpful and necessary step to recovery and is the main focus in these treatment modalities.

The authors also emphasized the need to avoid re-traumatization during therapy. But, aside from formal therapy, support groups are also available to help individuals who need it, providing another avenue to recommend for your patients. RAINN operates the National Sexual Assault Online Hotline. Additionally, a group called Surivors of Incest Anonymous provides resources to those with a history of childhood sexual abuse.