That's not the first time someone has called V a him or her. All it means is what the character believes.

I'm kind of glad that Malack is lampshading how long this arc has been. It's been enjoyable, but looong.

Q'arr is like V's bad angel, where Blackwing is his good angel. Q'arr will probably try to get V back in action to help the Order, since his bosses want to keep the conflict going.