Sam accepted a scholarship offer from the University of Missouri (Mizzou), after he was recruited by Craig Kuligowski, the team's defensive line coach.
Kuligowski recruited other players near Hitchcock, which made him familiar with Sam. He played for the Tigers, competing in the Big 12 Conference.
Sam was a consensus All-American and the Southeastern Conference (SEC) Defensive Player of the Year as a senior at Missouri.
As a senior, Sam drew attention for his strong performance against Michael Brockers in a game against Chávez High School; Brockers, an All-American, had accepted a scholarship to Louisiana State University.
He received scholarship offers from Arizona State University, Colorado State University, and the University of Houston, but he wanted to attend Texas A&M University, and waited for a scholarship offer from it.
After completing his college football career, Sam publicly came out as gay.
He became the first publicly gay player to be drafted in the NFL.