I am going out on a limb here, but I'm going to guess that most, if not all STDs, like headaches, don't exist anymore at this point in the future... I think you're underestimating the variety and versatile nature of diseases. Some viruses and bacteria can survive and adapt where more complex organisms would die off. (Remember that it took the Medical technology of the Federation until the middle of the twenty-fourth century to cure the common cold.) As always, an ounce of prevention is worth a pound of cure. Inoculation against common diseases would be standard operating procedure, but the side-effects of attempting to prevent every encountered germ in the galaxy would probably leave the patient a weakened pincushion. So it would make sense to require Medical exams prior to any ...exceptional personal interaction two people planned to engage in. Some people never even realize they are carrying a disease until symptoms appear or a doctor performs a routine test. Also there is a chance that an individual's body would naturally react to another person's chemistry as though they were a hostile infection. (Such as simple contact dermatitis.) It is nice to believe that diseases no longer exist, but not realistic. A significant number of Starfleet missions are transporting medical supplies to colonies, and fighting plagues and epidemics. Just as international air travel has made the spread of disease more of a problem, interstellar travel and exploration would be significantly worse so far as spreading previously unknown germs. Not everyone routinely subjects themselves to the decontamination algorithms of Transporters. Also, the Transporter programming cannot be aware of every tiny germ possibly carried by (or infecting) every known species. There are always more unknowns than knowns. (A blanket "assume it is germ/contaminant" protocol would be impractical as well - for example, by strict definition Trill would be recognized as parasites, because many of the benefits they provide their host are unquantifiable.) Instead of viewing the testing as unnecessary and intrusive, instead think of it as essential and just Starfleet's paternal way of making sure that the new couple "plays safe" and has the best possible chance of a consequence-free coupling. "Proper prior planning prevents [...]-poor performance." From my military experience, Starfleet could probably do quite a lot to anyone interfering with the crew's mission for selfish reasons. The United States' Uniform Code of Military Justice (UCMJ) goes above and beyond most civilian laws. (Again, another example: Adultery, while generally a quaint religious concept in civilian life, is well-defined and illegal under the UCMJ. Possible penalties include loss of rank and privileges.) The military rarely assumes individuals have the best of intentions. The top brass has to look out for the greater good at every turn. Any possible consequences would likely be at the Captain's discretion until the vessel returned to base. (I would imagine unapproved procreation would put both officers on mandatory leave until they were granted a review (if they were lucky enough to be granted one). Even then, it is probably common for one or both parents to be discharged to care for the offspring unless more suitable permanent arrangements can be made. That's what I was thinking too...so if you updated it, we would almost have to lose all the medical testing and so on. Are genetic issues widespread enough to even worry about in the Trek future? Wouldn't the most that it would require is a look over of medical records to determine anything? Anyways, I think, if you wanted to tackle this, it might be interesting to have - but it might be easier to just start from a blank page and go from their rather than try to rework this particular list. Cool find though. It's very interesting to see how Trek has changed with the times around it, and perhaps, how we have changed because of Trek? So far as I am aware, a physical and psych eval are still standard procedure when an officer undergoes a life change. (Such a being assigned to a new vessel or leaving service.) Marriage would certainly qualify. As far as realism is concerned, medical testing would be a constant. The genetic issues are a bit creepy, but not unreasonable. Starfleet Medical probably has an entire department of eugenics (not just to prevent possible genetic defects, but also to prevent any theoretical "natural" super-breeding program; Terrans would definitely want to prevent a second Eugenics War at any cost, even if the screening seemed intrusive.) If the possibility of breeding requires genetic sequencing/investigation, this seems to imply that genetic records are not standard or mandatory (likely also to prevent any intentional "breeding programs" for the creation of super-humans /-hybrids). From what I have seen, Starbase 118 might fall under scrutiny from Starfleet's Dept of Eugenics very soon -- our fleet seems to have quite a few hybrids whom have inherited the best of both parents without many (if any) defects of either! The atmosphere of Star Trek (and certainly the 70s-spawned TOS) was very pro-love and breaking down boundaries of prejudice, but all of the freedom was within a military framework which protected and propagated it. The one glaring flaw of the (accusedly Terran-centric) Regulation 1902 is in its very name: "Marriage". Casual intercourse in Star Trek seems common (and only more common in chronologically later series). So why would there be marriage regulations when "hooking up" is so easy and prevalent? In the context of the regulation itself, it seems that "marriage" is a convenient term for a sexual contract. The intent of Reg 1902 seems to be consciously governing intercourse regarding procreation (whether specifically intentional or "letting nature take its course). I believe interpreting Starfleet Marriage Regulations as having any but vestigial religious significance is a mistake. Clearly chapter 1902 is intended to provide a reliable framework for conscientious social contracts (even to the point of recommending a 1-year "trial" before any extended commitment) regarding sexual and social coupling. Also, as with most laws, the regs cover Starfleet's butt. If a captain does not want certain individuals fraternizing, it is not them being a jerk or racist - the couple just need to fill out more forms and submit to routine tests. Take a cold shower until the results get back!