AFAIK, AM/PM, which split the day in two halves, is mainly used in the Gregorian/Julian style calendars. Calendars that subdivide the day in different ways (the decimal calendar, some hindu calendars) split the day in many more chunks that are often more analogous to hours. In any case, because this would greatly complicate the logic for everyone who is using it, and not be super important to have for the smaller group of people using the handful of calendars that follow wildly different formatting rules (because they could use a dedicated custom formatting module in that case), I am for keeping the API simple and working with :am | :pm.
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