In Medieval Europe, attitudes toward homosexuality varied by era and region. Generally, by at least the twelfth century, homosexuality was considered sodomy and was punishable by death. Despite persecution, records of homosexual relationships during the Medieval period did exist. This persecution reached its height during the Medieval Inquisitions, when the sects of Cathars and Waldensians were accused of fornication and sodomy, alongside accusations of satanism. In 1307, accusations of sodomy and homosexuality were major charges leveled during the Trial of the Knights Templar. These allegations though, were highly politicized without any real evidence.
Although homosexuality was not considered a major offense during the early Roman Empire, homosexual encounters and homosexual behavior came to be viewed as unacceptable as Christianity developed. The Old Testament (Leviticus 18:22, 20:13, Deuteronomy 22:5) condemned females who wore male attire, males who wore female attire, and males that engaged in homosexual intercourse. In the 11th century, the Doctor of the Church, St. Peter Damian, wrote the Liber Gomorrhianus, an extended attack on both homosexuality and masturbation. He portrayed homosexuality as a counter-rational force undermining morality, religion, and society itself, and in need of strong suppression lest it spread even and especially among clergy.
Hildegard of Bingen, born seven years after the death of St. Peter Damian, reported seeing visions and recorded them in Scivias (short for Scito vias Domini, "Know the Ways of the Lord"). In Book II Vision Six, she quotes God as condemning same-sex intercourse, including lesbianism; "a woman who takes up devilish ways and plays a male role in coupling with another woman is most vile in My sight, and so is she who subjects herself to such a one in this evil deed".
In the 13th century A.D., the theologian Thomas Aquinas was influential in linking condemnations of homosexuality with the idea of natural law, arguing that "special sins are against nature, as, for instance, those that run counter to the intercourse of male and female natural to animals, and so are peculiarly qualified as unnatural vices." This view points from the natural to the Divine, because (following Aristotle) he said all people seek happiness; but according to Aquinas, happiness can only finally be attained through the Beatific Vision. Therefore, all sins are also against the natural law. However, the natural law of many aspects of life is knowable apart from special revelation by examining the forms and purposes of those aspects. It is in this sense that Aquinas considered homosexuality unnatural, since it involves a kind of partner other than the kind to which the purpose of sexuality points. Indeed, he considered it second only to bestiality as an abuse of sexuality.
In Mediterranean city states of the old world (ca. 40 B.C. to 400 A.D.), the norms by which a person carried out their private and public life were social and behavioral, rather than psychological or spiritual. Standards of human behavior were based on fulfillment of social expectations; for example, being a good citizen and bringing honor to one's family. It was considered one's duty to carry on the family line by marrying and raising children, regardless of sexual orientation.
For Roman citizens, marriage was a duty and was not meant for the purpose of fulfilling erotic needs. Therefore, it was considered normal for a male to look for sexual fulfillment outside marriage, though females did not have such liberty. Presumably, the main Greco-Roman moral view on human sexuality was that sexuality was good, as long as it did not interfere with a person's obligations to the state or family or involve the abuse of free children or married women. Other views stated that sexuality was dangerous and should be limited. People that held such beliefs would usually commit themselves to celibacy or limit their sexual activities either to marriage, or strictly for the purpose of procreation. Such views, though, did not preclude homosexual acts; they simply aimed to reduce promiscuous heterosexual activity.
Sexual orientation in Roman society was neither a questioned nor a judged matter. How a person expressed their sexuality was based and limited to class, age, and marital status rather than gender. Although there were a few exceptions, the higher a person's social status, the more limits a person would have. This included limitations on sexual acts and fewer sexual partners. For example, a high status male could penetrate another person, male or female, without damage to his social status; but for him to be penetrated by any person could possibly result in a loss of status. On the other hand, a slave's social status, or that of any other free male of a similar class status, would not be affected by any sexual act as long as the intercourse did not happen with another person the slave's owner allowed him to, or as long as it did not happen with an adult male citizen.
Penetration and power were highly correlated with the rights of the ruling elite in Roman society. It was acceptable for members of the less powerful group to surrender to penetration by members of a more powerful group. Thus, penetration was associated with a man's power and authority, and was not regarded as either a homosexual or heterosexual act. Although some scholars disagree, there is evidence that shows that lesbianism was not viewed as a problem; there were no laws restricting it. The Romans, perhaps because they were such a male-centered society, wrote little in their historical literature about women, especially lesbians.
Around 400 A.D., Christianity began to introduce a new sexual code focused on the religious concepts of "holiness" and "purity". The emerging Church, which gained social and political sway by the mid-third century, had two approaches to sexuality. One of these, like their Greco-Roman predecessors, did not view or judge sexuality in terms of heterosexual or homosexual acts. Instead, it only judged the act itself, and promoted a sex life that mainly focused on platonic relationships. Some point to the ancient Church's Brother-Making Ceremony as an example of same-sex marriage, but this is contested. For instance, the Roman tradition of forming a legal union with another male by declaring a "brother" persisted during the early Medieval years. Also, though there was no official marriage within religious communities, long lasting relationships or bonds were made. Also, there are many poems from that century that suggest the existence of lesbian relationships.
The main approach to Christian sexuality held an opposing view. Under this approach, sex was only meant for procreation purposes. Sexual activity for any other purpose, including heterosexual acts, was considered sinful. Such a view was inherited from aspects of late antique pagan ethics and was at first limited to abstinent Christian writers who were deeply inspired by Hellenistic philosophy. Eventually, it would be this approach to sexuality that was favored and spread throughout the Christian world because it limited sexual activity the most and appealed to an already understood principle. Ultimately, this approach would become the standard of Catholic orthodoxy.
By the end of the Middle Ages, most of the Catholic churchmen and states accepted and lived with the belief that sexual behavior was, according to Natural Law aimed at procreation, considering purely sterile sexual acts, i.e. oral and anal sex, as well as masturbation, sinful. However homosexual acts held a special place as crimes against Natural Law. Most civil law codes had punishments for such "unnatural acts," especially in regions which were heavily influenced by the Church's teachings.
In early Medieval years, homosexuality was given no particular penance; it was viewed like all the other sins. For example, during the eighth century, Pope Gregory III gave penances of 160 days for lesbian-like acts and usually one year for males who committed homosexual acts. During the Inquisition itself, it is unlikely that people were brought up for homosexual behavior alone; it was usually for publicly challenging the Church's stance against homosexuality. Those who did not back down would be severely punished.
As time went on, punishments for homosexual behavior became harsher. In the thirteenth century, in areas such as France, homosexual behavior between men resulted in castration on the first offense, dismemberment on the second, and burning on the third. Lesbian behavior was punished with specific dismemberments for the first two offenses and burning on the third as well. By the mid-fourteenth century in many cities of Italy, civil laws against homosexuality were common. If a person was found to have committed sodomy, the city's government was entitled to confiscate the offender's property.
By 1533, King Henry VIII had enacted the death penalty for sodomy, which became the basis for many anti-sodomy laws to establish the death penalty The Buggery Act 1533. This also led to the fact that although the Renaissance traced its origins to ancient Greece, none of the literary masters dared to publicly proclaim "males' love". 
The depiction of homosexuality in art saw a rise in the Late Middle Ages, beginning with the Renaissance of the twelfth century, when Latin and Greek influences were revitalized in Europe. Influenced by Roman depictions of homoerotic love, these "neo-Latin" poets portrayed male love in a positive light, while avoiding explicitly mentioning homosexuality, which was still a taboo topic. An example is the poet Marbodius of Rennes, who wrote of male beauty and desire:
A handsome face demands a good mind and a yielding one... this flesh is so smooth, so milky, so unblemished, so good, so slippery, so handsome, so tender. Yet the time will come... when this flesh, dear boyish flesh, will be worthless... be not slow to yield to an eager lover"
Poetry about homosexual acts in medieval Europe was not very widespread. One piece of writing that did describe homosexual acts was "Le Livre des Manières". Written by Étienne de Fougères between 1173 and 1178, his poems contrast the "beauty" of heterosexual sex to the "vile", unnatural homosexual sex. Seven of the stanzas focus specifically on lesbian sex acts:
"They do their jousting act in couples
and go at it full tilt;
at the game of thigh-fencing
they lewdly share their expenses.
They're not all from the same mold:
one lies still and the other makes busy,
one plays the cock and the other the hen
and each one plays her role“.
Noteworthy here, according to Sahar Amer, is that every stanza seems to decry the lack of a penis; Robert Clark Aldo notes “the ever-present but always absent phallus”. Amer also notes that the author may well have leaned on Arab treatises about sexuality, for metaphors and specific words pertaining to lesbian sexual activity.
Sexuality in the Middle Ages was male-centered and revolved around the idea that a man's penis was required to have fulfilling sexual activity. The lack of attention paid to lesbianism in the Middle Ages can stem from this belief, that as long as a dildo or other penis-shaped object was not used in lesbian relationships, then the relationship was not considered fully sexual.
Many of the writings that deal with lesbianism in medieval Europe come from religious texts. The earliest text that shows the Church's disapproval of lesbianism comes from the writings of St. Paul to the Romans. In his letters, he states: "women exchanged natural relations for unnatural, and the men likewise gave up natural relations with women and were consumed with passion for one another…and receiving in their own persons the due penalty for their error."
While Paul does not explicitly describe lesbian relations between women, he does state that this is an unholy choice made and that women who commit these "unnatural" acts will be punished, presumably by God's will. This is one of the earliest descriptions of lesbianism that details how early Church leaders felt about what were described as "unnatural" relations. The mentality of the church regarding lesbianism was also seen in the rise of penitentials. Penitentials were guides used by religious leaders and laypersons in dealing with issues in a broader community. While discussion of dealing with lesbianism was not mentioned in these penitentials, it was an overall concept that lesbian relations was a smaller sin than male homosexuality.
One such penitential that mentions the consequences for lesbian activity was the Paenitentiale Theodori, attributed to Theodore of Tarsus (the eighth Archbishop of Canterbury). There are three main canons that are mention in regards to female homosexuality: 12. If a woman practices vice with a woman, she shall do penance for three years. 13. If she practices solitary vice, she shall do penance for the same period. 14. The penance of a widow and of a girl is the same. She who has a husband deserves a greater penalty if she commits fornication.
According to his canons, Theodore sees lesbian activities as a minor sin, as fornication is considered, rather than a more serious sexual sin like adultery. Unmarried women and girls were judged less severely because they had a single status and did not have another form of sexual release. Married women, who had willing sexual partners in their husbands, were judged more harshly because they sought sexual satisfaction through an "unnatural" form. Religious figures throughout the twelfth and thirteenth centuries continued to ignore the concept of lesbianism but in St. Thomas Aquinas' Summa Theologiae discusses in his subject of lust that female homosexuality falls under one of the four categories of unnatural acts.
There were two medical situations that were linked to lesbianism in medieval Europe. Once such condition was that the womb of a woman had a buildup of her seed and due to lack of sexual intercourse, this cause the suffocation of the womb. The cure for this suffocation was for a midwife to place hot items on the woman and bring her to orgasm. This would help her to retain the seed of a man. The idea of one woman bringing another woman to orgasm was considered morally wrong by religious leaders and in the thirteenth century, it was urged that marriage was a solution for this problem rather than manual stimulation. The second ailment was ragadia of the womb, in which fleshy growths grew as a result of intercourse or childbirth and these growths could sometimes grow on the outside of the vagina. These growths resembled penises and it was thought that women with these would be able to have heterosexual sex with other women because a penis was needed to have intercourse. Eventually the practice of masturbating women and the idea that women with the ragadiae would have sex with other women disappeared over time, further masking lesbian activities in medieval Europe.
Laws against lesbianism in medieval Europe were not as mainstreamed as laws for male homosexuality. While not as serious, lesbianism still posed a threat to male-centered social order. It was often ignored in secular law but there is one known exception. Written around 1260, the French legal treatise Li Livres de jostice et de plet prescribed that if convicted of sodomy: "The woman who does this shall undergo mutilation (on the first and second) offense and on her third must be burnt." This is one of the only laws that has been known to specify what the consequences were for women who engaged in lesbian sexual activity. By the thirteenth century, lesbianism was equated to sodomy and therefore carried a similar sentence. However, secular courts did not prosecute cases of lesbianism, mainly because laws that would cause it to be brought to court barely existed.
A single courtly love poem exists, written by one Bieiris de Romans and addressed to another woman named Mary, which several scholars have argued is in fact expressing homosexual female love. The issue is heavily debated in scholarship, however, as nothing else is known about Bieiris (Beatrice) other than the poem itself. Some scholars argue that she was writing on behalf of a man, others that she was simply playing with the format and using the same register of affectionate language common in everyday society at the time: the poem never mentions "kissing" Mary but only praising her character, making it unclear if the "love" that Beatrice was expressing was romantic or platonic. A counter-argument made by other scholarship is that the very fact Beatrice chose to use a poetic format so traditionally used to express romantic love means she must have known it would be understood as expressing a romantic context.