Ilario, A Story of the First History is a novel by Mary Gentle, published as two novels in the USA, set in an alternate history where Carthage has become a powerful medieval empire.
Set in the same alternate medieval world as Gentle's Ash: A Secret History sequence, Ilario, A Story of the First History is more limited in scope.
The protagonist, Ilario, is an intersex person seeking to serve as apprentice to a master painter, a path that takes Ilario from Iberia to Carthage, Rome, Venice and Constantinople.
[1] Roz Kaveney, reviewing The Lion's Eye for Time Out described the book as "action-packed, deeply intelligent novel a focus for intrigue, intellectual debate and a fair amount of polymorphous hot sexual action".
[2] Strange Horizons found the book "something of a disappointment", with "precious few changes of tone".