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Identifying mechanisms associated with this inequity is critical to advancing preventative and responsive treatment. Blunted cortisol reactivity to psychosocial stress represents one possible mechanism, though the influence of sex and specific dimensions of trauma on this condition are underinvestigated. This study examined the roles of sex, developmental timing of trauma, trauma subtype, and subjective trauma impact on cortisol reactivity. Adults (<jats:italic>N<\/jats:italic>\u00a0=\u00a059, <jats:italic>n<\/jats:italic>\u00a0=\u00a037 female) participated in the Trier Social Stress Test, completed trauma measures, and provided salivary cortisol samples. Multiple regression analyses were performed to investigate correlates of blunted cortisol reactivity in the full sample and in sex\u2010disaggregated data to account for unique endocrinological milieus. Women who endorsed childhood trauma demonstrated blunted cortisol reactivity, <jats:italic>B<\/jats:italic>\u00a0=\u00a0\u22128.72, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.004, <jats:italic>f<\/jats:italic> <jats:sup>2<\/jats:sup>\u00a0=\u00a0.39; notably, this association held only when participants endorsed the childhood traumatic event as their most stressful lifetime event. Considering the lack of clarity regarding the conditions under which blunted cortisol reactivity develops, these findings provide insight into factors that may confer risk for these psychophysiological changes. The observed salience of sex\u2010disaggregated analysis has important implications for future research. Despite decades of study, the pathways linking trauma, cortisol dysregulation, and pathology remain elusive; accounting for sex differences may contribute to resolving this quandary. Unraveling these mechanisms could inform prospective risk assessment, prevention efforts, and focused clinical trials.<\/jats:p>","DOI":"10.1002\/jts.23159","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T23:09:35Z","timestamp":1745276975000},"page":"707-719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Not small men: Sex\u2010specific determinants of cortisol reactivity to psychosocial stress following trauma"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8126-2138","authenticated-orcid":false,"given":"Liza","family":"Hinchey","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine  Detroit Michigan 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Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Javanbakht","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine  Detroit Michigan 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