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 identity," and "transgender," and outlines the procedures for a transgender student to participate in activities. The policy must ensure confidentiality of a student's medical information, require written notification from the student and their parent to the school administration, and establish criteria for determining eligibility based on the student's gender identity as it relates to their biological sex at birth.

Additionally, the bill stipulates that the school board must evaluate documentation provided by the student to confirm their gender identity and expression, including medical verification if applicable. It also includes provisions for an appeals process for denied applications, requirements for restroom and locker room usage, and clarifies that participation eligibility is based on the biological sex noted on the student's birth certificate unless otherwise approved. Importantly, the bill emphasizes that it does not encourage students to undergo medical treatments related to gender transition.