Karen,
I have been in the exact same place with my spouse. I have also left and gone for a drive after a few conversations.
In the end I always come back and we both apologize and try to set things right. My wife knows about my gender issues and while,she wishes it wasn't a part of her life, she understands that I have to deal with it every day.
I agree with way2real---I try to make my wife know I love her when I can--and I probably don't do it enough. When she sometimes struggles with my gender issues-- she eventually looks back on all the things I have done to show her that I love her and she remembers them. She also realizes how lucky she is because very few men do as much for their wives as I try to do.
In the end we always come back to the love we have for each other and the many times every day, week and year that we show it to each other.