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 consistent gender identity and expression, as well as an appeals process for denied applications.

Additionally, the bill stipulates that eligibility for activities separated by male and female teams is based on the biological sex noted on the student's birth certificate unless the student is approved for participation as a transgender student. It emphasizes that the policy should not encourage students to undergo medical treatments related to gender transition and clarifies that it does not affect existing policies allowing cross-gender participation when no appropriate team is available.