In a 2020 study published in the Journal of Trace Elements in Medicine and Biology, researchers conducted an in vitro experiment to analyze the effects of TiO2 nanoparticles on a human neuroblastoma (SH-SY5Y) cell line. The scientists evaluated “reactive oxygen species (ROS) generation, apoptosis, cellular antioxidant response, endoplasmic reticulum stress and autophagy.” The results showed that exposure to the nanoparticles “induced ROS generation in a dose dependent manner, with values reaching up to 10 fold those of controls. Nrf2 nuclear localization and autophagy also increased in a dose dependent manner. Apoptosis increased by 4- to 10-fold compared to the control group, depending on the dose employed.” 

Anyway, it doesn't matter if it reflects or absorbs, Titanium Dioxide is a pretty awesome sunscreen agent for two main reasons: it gives a nice broad spectrum coverage and it's highly stable. Its protection is very good between 290 - 350 nm (UVB and UVA II range), and less good at 350-400 nm (UVA I) range. Regular sized Titanium Dioxide also has a great safety profile, it's non-irritating and is pretty much free from any health concerns (like estrogenic effect worries with some chemical filters).