Seriously, it has been almost 4 years. Why is sex still so hard for him? So much performance anxiety, sexual dysfunction..........why? Years of therapy, treatment and 12 step so why??

I feel like it is getting better than it isn't...I hope I don't sound unfeeling but after all the above, he still doesn't have an answer as to why all the ejaculation issues. If he still doesn't know, how wwill we ever get past this?