Same guy as this comment, just remembered my password on this account.
I have done some more testing and found more issues. The issue described above is still the same, and applies to all sims, except when it doesn't. I haven't been able to figure out what makes it sometimes work properly. It is worth noting that the interactions seem to come back occasionally, once again allowing for one interaction before no longer working.
There is a new issue which I have been able to tie back to this, which involves attraction. This issue so far seems to only be affecting one family. In short, attraction is not working at all. A sim set to be sexually and romantically attracted to men and women is rejecting people based on attraction, which should not be possible. Romantic interactions still show up, but are grayed out. When cheating their relationship and going into cas and back out they are able to do interactions, but then the first bug happens.
A third issue is sims sometimes rejecting normal sex despite "always accept normal sex" being enabled. Seems to have to do with teen sims, in one of my attempts it was a teen sim asking for it, in another it was asking for it from a teen sim. In the second case, asking as the teen sim worked, but he continued to reject that specific sim afterwards even with a full romance bar.
EDIT: Turns out I am an idiot and forgot to update some of the files, leaving me with files of 2 different versions of the mod. Properly updating it fixed it.