For that, you need to add SEX to the ID side of your formula:
dcast(PC1, ID + SEX~CAT, value.var='AMT', fun.aggregate=sum, na.rm=TRUE)
# results in:
ID SEX A B C
1 1 Female 46 22 31
2 2 Male 17 25 44
Things on the left hand side of the formula are kept as-is, things on the right-hand side are cast.