

hypothetical medication that would harm me if the doctor thought I was a cis man and didn’t out myself
Not that I’m accusing you of anything, but this is a hypothetical that I hear a lot from transphobes (ie, "would you take the medication only for “biological” men / women despite being a trans woman / man? If so, ha ha! You admit to being your AGAB really. If not, ha ha! You die).
Other than questions of what anatomy is physically present, I’ve never heard of (and sincerely doubt the existence of) any case where birth sex is relevant.
Is not liking androgynous people something your wife has actually told you about her sexuality? Because all the bi people I’ve heard have represented it as liking both “same and different” rather than “binary men and women”. It can, as you say, take time to adjust, though.
Also note that HRT can be more like an exponential dropoff: it can take years to get the full effects, but a HUGE amount will happen in the first six months or so.