The Fairness in Women's Sports Act mandates that participation in school-sanctioned sports be determined by an individual's biological sex at birth. It requires public and nonpublic schools, as well as institutions of higher education, to designate athletic teams based on biological sex, explicitly prohibiting male students from participating in teams designated for females, women, or girls. In cases where a student's sex is disputed, the bill outlines that a signed physician's statement must be provided, confirming the student's sex based on their reproductive anatomy, testosterone levels, and genetic makeup. Additionally, the bill protects schools and institutions from investigations or adverse actions for maintaining separate teams for female athletes.

The legislation also establishes a private cause of action for students who are deprived of athletic opportunities or suffer harm due to violations of the bill, allowing them to seek injunctive relief, damages, and other legal remedies against the respective school or institution. Students facing retaliation for reporting violations are similarly granted the right to sue. Schools or institutions that experience harm from violations can also pursue legal action. All claims must be initiated within two years of the harm occurring, and prevailing parties are entitled to monetary damages, including compensation for psychological, emotional, and physical harm, as well as reasonable attorney's fees and costs.