Making gender toggles is a massive effort, particularly for the manager/therapist as they have the most scenes/lines of any character, just to do pronoun/appearance toggle (as is the case with the M->F toggles) would be an estimated 40-50k words + art... and that's just pronouns, to give your boss a penis (which... I'm pretty sure is a core requirement for such a toggle) would easily double that wordcount, which means we're approaching a full release worth of writing/work (an average release is ~80k words), and that's a steep bar to justify, the F->M toggle was heavily aided by a fan jumping in to do most of the gruntwork, while there has been the occasional request for the M->F toggle, nobody has volunteered to help (and needing to write new scene variants rather than just flag pronouns means there would still remain a lot of work that I would need to do).
As much as (for symetry, if nothing else) being able to toggle gender + genitals for every character would be nice... the game is ginormous, and back-adding would be a massive effort and there are other priorities.