Sex difference considerations can impact the outcome of radiation effects and response in many ways, from basic biology (i.e. genetics, pathways), phenotype (natural history of the disease), co-morbidities, lifestyle, radiation exposure, biodose, systematic/systems approach (i.e. individualized response), through medical response. Overall, these areas can be broken down into subcategories: 1) key considerations; 2) factors that impact injury; and 3) response in an ARS setting - how this state-of-the-science would be used today. Ultimately, this information can be used to inform radiation research and medical response to radiation exposure.