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 female-designated teams from being open to male students and outlines a process for establishing a student's sex in cases of dispute, which includes a signed physician's statement based on reproductive anatomy, testosterone levels, and genetic analysis. Additionally, schools and institutions will not face investigations or adverse actions for maintaining separate teams for female athletes.

The bill also provides 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 recourse if they experience harm due to violations. 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.