This chapter examines the growing inclusion of transgender student‐athletes as well as the barriers that transgender student‐athletes continue to face in intercollegiate athletics. The chapter concludes with a discussion of suggested practices and implications.

Objective: To compare concussion knowledge between US born and internationally born collegiate student-athletes. Furthermore, to investigate whether length of time in the United States impacted concussion knowledge. Design: Survey. Setting: Preparticipation physicals at a midwestern NAIA college. Participants: Three hundred one collegiate student-athletes. Interventions: Demographic questionnaire and the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS). Main Outcome Measures: t test was used to determine whether a difference in Concussion Knowledge Index (CKI) scores exists between US born and internationally born student-athletes. A one-way analysis of variance was used to determine significance for length of time in the United States. Results: A statistically significant difference was found for CKI scores between US born (19.22 ± 2.38) and internationally born student-athletes (18.01 ± 2.57) (t = 3.895, P = 0.000). Analysis of variance demonstrated statistically significant difference for CKI scores (F 2,300 = 13.883, P = 0.001). Post hoc analysis found significant differences in CKI scores between US born (19.22 ± 2.38) and internationally born student-athletes in the United States less than 2 years (17.31 ± 2.52) (P = 0.000), and between internationally born student-athletes in the United States 2 or more years (19.15 ± 2.25) and internationally born student-athletes in the United States less than 2 years (17.31 ± 2.52) (P = 0.002). Conclusion: Among this sample, being born in the United States and length of time in the United States contribute to student-athletes' concussion knowledge. Clinical Relevance: Standardized guidelines are needed to assist health care professionals in properly educating student-athletes about concussions as the recognition and management of concussions can be affected by a student-athlete's knowledge.

Context Mental health is a significant issue in the United States, with approximately 18.5% of adults and 22% of adolescents having a diagnosable mental illness. Athletic trainers are in a prime position to recognize signs of mental health illness in their patients and to facilitate referral to a mental health professional. Objective To introduce interactive approaches for developing mental health first aid and referral skills in professional athletic training students. Background Although the 2020 Commission on Accreditation of Athletic Training Education curricular content standards require programs to educate students about identification and referral for mental health conditions, the standards do not provide specific suggestions for instructing this content. Description Three educational activities have been implemented into the curriculum: an exploratory counseling session, Mental Health First Aid certification, and a standardized patient encounter. Clinical Advantage(s) The exploratory counseling session improves athletic training students' empathy for individuals living with mental illness. The Mental Health First Aid curriculum has been shown to raise awareness of mental health conditions and positively influence the number of people who receive professional help. Standardized patient scenarios have been shown to increase critical thinking and confidence with mental health cases and to increase knowledge in mental health assessment. Conclusion(s) Students' reflections support that these components have increased their competence and confidence in recognizing, intervening, and making referrals for individuals with suspected mental health concerns.

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