I’m not saying that the Middle Ages was a great period of freedom (sexual or otherwise), but the sexual culture of 12th-century France, Iraq, Jerusalem, or Minsk did not involve the degree of self-loathing brought about by modern approaches to sexuality. Modern sexual purity has become a marker of faith, which it wasn’t in the Middle Ages. (For instance, the Bishop of Winchester ran the brothels in South London—for real, it was a primary and publicly acknowledged source of his revenue—and one particularly powerful Bishop of Winchester was both the product of adultery and the father of a bastard, which didn’t stop him from being a cardinal and papal legate.) And faith, especially in modern radical religion, is a marker of social identity in a way it rarely was in the Middle Ages.
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