Amends GS 115C-12(23), regarding the State Board of Education's (State Board) duty to adopt rules governing interscholastic athletic activities conducted by local boards of education, to add the following requirements to the mandated content of rules applicable to middle schools and high schools. Requires all teams participating in interscholastic or intramural athletic activities to: (1) have each team expressly designated by the biological sex of the team participants as either males/men/boys, females/women/girls, or coed/mixed and (2) require teams or sports designated for females/women/girls not be open to students of the male sex and teams or sports designated for males/men/boys not be open to students of the female sex (unless there is no comparable female team for the particular sport and the sport is not a contact sport), where a student's sex is recognized solely based on the student's reproductive biology and genetics at birth. Establishes a private cause of action for the following, subject to a two-year statute of limitations: (1) a student who is deprived of an athletic opportunity or suffers or is likely to suffer from any direct or indirect harm as a result of a violation of the above requirements; (2) a student who is subjected to retaliation or other adverse action by a public school unit, athletic association, or other organization as a result of reporting a violation of the above requirements to an employee or representative at the public school unit; athletic association; or any local, State, or federal agency with oversight of the public school unit; and (3) any public school unit or its representatives or employees who suffer any direct or indirect harm for complying with the above requirements. Provides for remedies including injunctive relief, protective order, writ of mandamus or prohibition, or declaratory relief, as well as actual damages, including for psychological, emotional, or physical harm; reasonable attorneys' fees; and costs. Requires the State Board to monitor middle and high schools for compliance, and requires reporting schools in violation to the Joint Legislative Oversight Committee. 

Amends the following statutes to require middle and high school athletic teams at charter schools, regional schools, and lab schools to comply with GS 115C-12(23), as amended: GS 115C-218.75, GS 115C-238.66, and GS 116-239.8. 

Enacts GS 115C-567 to require nonpublic schools that are members of an organization that administers interscholastic athletic activities pursuant to Article 29E, and any other nonpublic schools that organize athletic teams at the middle and high school level that plays a team from any school required to comply with GS 115C-12(23), to comply with GS 115C-12(23), as amended.

Applies beginning with the 2023-24 school year.