The drawing is based on the vision of hell described in the Apocalypse of Peter, which was written in the 350s AD.
Before Dante Alighieri published his own Divine Comedy, there were very different ideas about life after death within the church. Both men and women received divine visions in which they were presented with heavens and hells.
One of the earliest written visions is the Apocalypse of Peter, written in the 350s just after Christianity had become the official religion of Rome. It is also the first surviving text of this type since the Revelation of John. It is also one of the apocryphal books left out of the Church Bible.
Underlying the Apocalypse of Peter is the idea that homosexual behaviour is an unnatural reversal of direction and role; a man behaves like a woman and vice versa. That’s why the condemned in hell have to change direction all the time, first climb up and then jump down, and up again… endlessly.