To identify sex-based differences in self-reported and close other–reported perceptions of communication behaviors in adults with traumatic brain injury (TBI).Between-groups comparison of questionnaire data from men and women with TBI and their close others.University academic department.Adults with medically documented TBI (n=160) and adults without TBI (n=81; control group) (N=241).Not applicable.La Trobe Communication Questionnaire, a standardized measure of communication problems in everyday life.Participants with TBI endorsed more communication problems than controls (P<.001). There were no significant differences in self-ratings (P=.20) or in the ratings of close others (P=.09) in communication behaviors of men with TBI compared with women with TBI. There was no difference between the self-ratings of women with TBI and their close others (P=.59). However, men with TBI significantly underreported communication problems compared with reports of close others (P<.001).Women with TBI might be more accurate than men with TBI in recognizing their own pragmatic communication problems.