My point was that it doesn't actually think like that. For example, prompting StableDiffusion for a picture of a doctor doesn't necessarily get it to draw a human at all, much less a doctor of a pre-determined sex; instead, StableDiffusion de-noises the image until the result emerges, where that result would (ideally) contain a doctor of whatever sex it happened to come up with.
That said, you're right that we can add more code to try to guide things.
We could even just brute-force it by just re-generating images over-and-over, or tweaking them after generation, until they match exactly what we wanted. (Realistically, something like branch-and-bound would probably be preferred to blindly guess-and-check-ing.)