I've not noticed any issues with it. I've changed gender, names, age, relationships...and no problems.
Example: There was a bug that caused single child households to spawn. I grabbed a single (some times 2) randomly generated townie, gave them a big house (built like a parent/child community house for them) and then added the children to that household. I've had different combos of those households, some I've changed to be single parent families, with the kids all being siblings, others not.