How would you like that portrayed in game? The only place gender reference shows up is when other people reference us while talking to others, and that happens only very rarely. The extreme vast majority of the time, saving only two or three examples, it happens coming from individuals who only just met us, or who haven't met us at all, and who generally do not know us in the slightest.
At the risk of wading into something I have no intention of engaging further with, I would personally find it extremely immersion-breaking and jarring to have every individual in the world automatically psychically know our character's reference preference on first sight... in fact it's a deeply unhelpful and unhealthy trope that has been happening, where people act, assume and roleplay as though non-binary identifying individuals are somehow magically visible as such from a hundred feet away; we're not. People don't know that; it's not visible. So when the bandit sees me trying to sneak explosives into their base, and sees my distinctly female physical body, that bandit will point and shout "stop her!". They won't stop to ask my reference preference, and they won't know it automatically either. That's okay; I wouldn't expect them to. It would be unfair of me to expect them to.
The only place where this could realistically come up would be for companions and camp followers, and even then, it can only come up when they are talking to someone else about us - an extreme, extreme rarity. We can suppose, yes, that if it's important to the character, that they will inform their camp followers and allies of it in the grey off-camera space of camping and travelling together... so after a short while travelling together, they might be marked to use your preference from a list of three (male, female, unknown/neutral), since each would require a rerecording. You might hear those references three times in the course of your entire game; that will certainly be worth it to some, I'm not denying that... but it would be an exceptionally minor impact on the game, for what would be a lot of extra work with the flagging and code base and choice ui design and line recording.
