just for a little clarification, i believe that she does in fact use she/her pronouns, but is in denial about not being a girl?? i'm not 100% sure, but in the card shown of her on the page here, it says, "loves femininity despite it being the death of her (god, she is not a girl, but she will never admit it to herself." so i don't think it's wrong to use she/her pronouns, per say, but it doesn't do any harm to keep in mind she's probably not a girl. hope this helped!! ^^
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from my undertanding, and after having triggerd specific dialog options on the "good ending" route, I think they are more queer gender than anything. whether as a trauma response or due to what being a "woman" means for the enviroment they were raised in, it seemed like they kind of felt some sort of disconnection to it.
In game, the only character I've noticed using any pronouns when talking about them is Ronin, who specifically only uses "they/ them" whit Ther, but since the creator has referd to them as a "she", then we can safely assume both ways are okay¿