Oh, that worked haha. Aspect ratio is correct, and black frame insertion is working. The catch is, at the (more) correct refresh rate of 119.17hz, there's a crt-like strobing effect. I don't mean the actual black frame insertion, I mean there's a lighter coloured horizontal bar crawling up the screen. With 120hz it isn't there, and the whole screen (most of it - I'll get to that) is uniformly dark, as I think it should. A benchmarking program shows that the game is running at 120fps with 120hz though, which isn't ideal.
Also in both cases there's a permanent horizontal bar near the top of the screen that doesn't seem to be affected by black frame insertion. That part of the screen looks just like it does with the option disabled.
I've attached the details of my custom resolution in case there might be something relevant there.