Perhaps there are no seats in 1st on the flight in question. Also, you haven't said whether you are expecting to pay for the upgrade. Medical conditions notwithstanding, first class costs money, and airlines won't give away a first class seat for an economy fare. Maybe they don't have first class on that route. Without more information from you, it's pretty hard to tell.
With respect, the travel agents have access to more information than you do. That's why you pay them for a service - otherwise you'd be doing it yourself. In point of fact, I'm not sure why you aren't - for most airlines, it's cheaper to speak to them direct.
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