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Objective To compare sex differences in alexithymia (poor emotional processing) in males and females with traumatic brain injury (TBI) and uninjured controls. Setting TBI rehabilitation facility in the USA and a University in Canada. Participants Sixty adults with moderate to severe TBI (62% males) and 60 uninjured controls (63% males) DESIGN Cross-sectional. Main measures Toronto Alexithymia Scale-20 (TAS-2. Results Uninjured males had significantly higher (worse) alexithymia scores than uninjured female participants on the TAS-20 (p