Sorry if this is prying, but are you totally impotent, or just when trying to consummate? If you are still "polishing the ole bayonet" on occasion, but unable to consummate with your wife, it may be fear of rejection, depression, or even actual (albeit subconscious) rejection on her part. I ask because you mention "I think I need, somehow, to deal with her inadequacy issues as well." Somehow, I'm sensing that there is more at work here than just the physical. Taking beginning steps (low e) toward transition or at least gender accommodation as well as bph, can take a toll on your manly side, then the added stress of family tension and strife are not conducive to the kind, loving sharing of sex. You said you would like to penetrate her, does she feel the same way? I don't know how old you are but men usually get bph at an age where the wife may be going through her own change. Damn, that could be a powder keg. IF that is the case, she would be experiencing a "sense of inadequacy" even without your changes. Is it possible that you don't need another drug in the mix, but rather a counselor? Again, just asking because sometimes it is hard to look at ourselves objectively, and even harder to look at our relationships. At least until we screw it up, they kick us to the curb, and we have lots of time to realize we were part of the problem, not the solution. I know how important my marriage is, so wishing you the best.