An area that has not been closely considered in the sporting world is the mental health effects on the competitive athletes who identify as Lesbian, bisexual, gay, transgender, queer/questioning (LBGTQ+) and thus, experience discrimination because of their sexual identity. Considerations include concepts an athletic trainer should keep in mind when caring for patients/athletes who identify as LBGTQ+. This article reviews the mental health impact of sexual minority identity stress on LBGTQ+ individuals, steps to address discrimination for those in athletics who identify as LBGTQ+, legal ramifications in the workplace for the LBGTQ+ individual, and the tragic consequences when LBGTQ+ individuals lack coping skills for stress and pursue suicide as a way to cope. Strategies are provided to improve the outcomes, prevent suicide, and create an environment of inclusivity.