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, detailing the student's sex based on their reproductive anatomy, testosterone levels, and genetic makeup. Additionally, schools and institutions will not face investigations or adverse actions for maintaining separate teams for female athletes.

The bill also establishes a private cause of action for students who are deprived of athletic opportunities or suffer harm due to violations of its provisions. Students facing retaliation for reporting violations will have the right to seek legal remedies against their school or athletic organization. Schools that experience harm from violations can also pursue legal action. All claims must be initiated within two years of the incident, and those who prevail in their claims are entitled to monetary damages, including compensation for psychological, emotional, and physical harm, as well as reasonable attorney's fees and costs.