Tbh I don’t even know why the option even exists. I have 2 days worth of playtime and not once does it go on about pronouns or anything like that. So to me the menu seems completely pointless. If i can recall i also don’t think the NPCs have even referred to me as male or he/him. Maybe Bethesda added it last minute or something to try to appeal to a larger group of people idk. I’m just enjoying my spaceship man.