Our study aimed to elucidate the relationships between both biological and sociocultural factors on the ability to visualize cross sections, with a particular focus on sex and hormonal status, as well as emotional context and gender roles. While it is recognized that sex hormones play a role in shaping spatial abilities, the mechanisms remain unclear, and the effects of hormonal contraceptives, such as oral contraceptives (OCs) and intrauterine devices (IUDs), are largely unexplored. We recruited males (n = 35) and females across different menstrual cycle phases (early follicular (NCF, n = 34); mid-luteal (NCL, n = 36)) and contraceptive methods (users of OCs, n = 27; users of hormonal IUDs, n = 31). Participants' ability to identify two-dimensional (2D) cross sections of three-dimensional (3D) solids was assessed using the Cross Section Task (CST). CST was performed after an emotion regulation task involving negative and highly negative pictures. Males outperformed NCF, NCL, and OC users, while IUD users showed comparable performance to males, suggesting a potential mitigating effect. Moreover, a multiple linear regression model for females showed that IUD users performed significantly better on the CST task than OC and NCL females, and marginally better than NCF females, after adjusting for age, emotional arousal, femininity, masculinity, and testosterone. Emotional arousal, especially following the emotion regulation task, associated with females' CST accuracy and partly mediated sex differences in the ability to visualize cross sections. Our findings advocate for further exploration of spatial performance advantages in IUD users, as the data suggest that hormonal IUD use may be related to the systemic changes in women's bodies, including the brain, potentially influencing spatial abilities. Moreover, our results highlight the importance of considering emotional factors in understanding sex differences in spatial tasks.