@arak2002, I will let someone from the core team respond to your specific questions (which probably won’t happen until Monday India time at the earliest).
@cintiadr, OpenMRS support for this is badly lacking. (And Bahmni support is no better.) The OpenMRS data model has person.gender as varchar(50), which at least gives the possibility of fixing this, but the application layer presumes the only legal values are “m” or “f”.
Since no OpenMRS implementation has ever prioritized this issue, and (I guess) there is extremely limited medical treatment of trans people in resource-limited environments, so I couldn’t put any sort of timeline to when this will be addressed. But I have created a placeholder ticket at in case some ally wants to pick this up: