This bill mandates that each school board in Nebraska develop and adopt a policy regarding the participation of transgender students in extracurricular activities. It defines key terms such as "biological sex," "gender," "gender eligibility," "gender expression," "gender identity," and "transgender." The policy must ensure confidentiality of a student's medical information, outline procedures for participation, and establish criteria for eligibility based on the biological sex noted on the student's birth certificate. It also requires documentation to support a student's application to participate as a transgender student, including medical verification and statements affirming the student's gender identity.

Additionally, the bill stipulates that if a transgender student is approved for participation, they must use facilities associated with their biological sex unless alternative arrangements are made. It emphasizes that eligibility for activities separated by male and female teams is based on the biological sex noted on the birth certificate unless the student is approved for participation as a transgender student. Importantly, the bill clarifies that it does not encourage students to undergo medical treatments related to gender transition and maintains existing policies that allow for cross-gender participation in sports when no appropriate team is available.