There are no requirements or rulings stipulating how these values are to be handled. These values are independent of a persons legal name. These values are independent of a persons legally identified sex.
There is no requirement for an individual to provide their gender to an organisation. Valid values to choose from are Male (M), Female (F) and Other (X). Any individual has the right to specify X if they do not want the organisation to know their gender.
No other values for gender beyond M, F and X should be used. From a technical point of view, X can be considered the NULL component in this trinary logical scenario. As a NULL value its meaning can be M, F, unknown, not yet known or not able to be provided.
An organisation has no right to change or modify this value especially if they perceive it conflicts with their viewpoint of what gender and titles are. As they are not the owners of this data, but the custodians, only the individual owner has the right to enact a change on this value.