Reinstating this thread as I have exactly the same issue. Installed GSX demo several months ago and ran it very successfully with fsdt Lszh for a few weeks. But not used it for a few months - busy beta testing an AC etc. Tried gsx today (intention was to buy it and start flying for myself for once)- but immediately ran into the problem outlined above except that the "compatibility" solution does not help.
In sum - and watching task manager, and using either automatic or manual load set in the exe.dll, couatl.exe initially loads but immediately disappears and of course never shows on the FSX menu.
I have tried several reinstalls, have MSE "off" and have tried other options suggested in other posts. also restored via widows restore back a month - all to no avail (and of course LSZH has the same problem hat couatl will not load even with GSX uninstalled
Something must have changed in my system and is forcing couatl to shut down but I am at a loss where to look next so grateful for any advice .....
Many thanks
John R