The bill mandates that school athletics be categorized by the biological sex at birth of the participants, requiring public schools and private schools that compete against public schools to designate their interscholastic sports and club athletic teams as either male, female, or coed/mixed. It explicitly prohibits biological males from participating in athletic teams or sports designated for females. The determination of a student's sex for participation eligibility is to be based on the student's original birth certificate or a certificate issued upon adoption, with provisions for what constitutes an acceptable certificate. If the original birth certificate does not clearly indicate the student's sex at birth, the student must provide other evidence at their own expense.

The bill also establishes various causes of action. Students who are deprived of athletic opportunities or suffer harm due to a school knowingly violating the new rules can seek injunctive relief, damages, and other legal remedies. Similarly, students who face retaliation for reporting violations, as well as schools that suffer harm from such violations, can take legal action. All civil actions must be initiated within two years after the harm occurred, and successful claimants are entitled to monetary damages, attorney's fees, and other appropriate relief. The bill includes a severability clause to maintain the remainder of the act in case any part is deemed invalid, and it is set to take effect 30 days after passage.