The "Fairness in Women's Sports Act" mandates that participation in school-sanctioned sports in New Jersey 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, specifically categorizing them as male, female, or coed. The bill explicitly prohibits athletic teams designated for females from being open to male students. 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 legal recourse for students who are deprived of athletic opportunities or suffer harm due to violations of its provisions. Students can pursue private causes of action for injunctive relief, damages, and other legal remedies against schools or institutions of higher education. Furthermore, it protects students from retaliation for reporting violations and allows schools to seek legal action if they experience harm due to violations of the bill. 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.