Your wife is not keeping up her end of the bargain. No, it isn't her fault that she has a mental illness, but it IS her responsibility to heal. Right now she's just taking a bunch of pills. Well, that does just about nothing... It seems like doctors just hand out pills like they are candy and expect patients to get better that way. Well, that's not how medication was presented to me. I was told that medication enables me to go to therapy so that I can do the hard work myself. And yes, that's exactly what I did, and I no longer need a daily medication now. I understand that not everybody can get off of meds completely, but my point is that meds will only do a small portion of the work, and the rest is done through therapy. If her meds aren't even allowing her to get to the point where she can do therapeutic work, then I'd argue that the meds aren't doing much for her.

You've done MORE than enough in this marriage. It takes two to make things work, and right now you are very much functioning as a singe parent.

I have obsessive tendencies myself (but I'm not diagnosed with OCD). I worry that her obsessions are what's driving her to control you. Is she getting any help with these obsessive thoughts?

As for the porn thing, I don't understand why so many women get so hung up on it. But, that's neither here nor there as you gave it up cold turkey and its not a part of your life anymore. You've done a lot to try to earn back her trust. I'd say at this point, if she's not trusting you, then getting the old snip-snip isn't going to make those trusting feelings come rushing back. Don't have a surgery that you aren't all for 100%. Its your body, and you shouldn't be manipulated into having surgery.