Now, activists and organizations are reacting to the policy, which they say discriminates against transgender students.
The Perkiomen Valley School Board rejected the bathroom policy when they voted on it last month.
However, when Policy 720 came up for a vote again this week, it passed 5-4.
The American Civil Liberties Union (ACLU) warns, though, that the new policy could lead to lawsuits.
The debate over the proposal came to a head Monday night with shouting and a person being kicked out.
It requires students to use bathrooms that align with their sex assigned at birth. Transgender students would not be allowed to use the restrooms or locker rooms that correlate with their gender identities.
"I thought a bathroom policy was the best thing to do. I work in healthcare, I cover hospitals to Philadelphia to Maine. They all are dealing with the bathroom issue," said school board member Matt Dorr, who voted in favor of the policy.
Fellow school board member Dr. Tammy Campli disagreed.
"(Policy 720) does not consider Title IX, it does not bring into the fact that we're going to be in lawsuits," she said.
The ACLU echoed that sentiment in a statement to Action News that read in part: "...The policy not only harms transgender young people but could subject the school district to costly litigation. We encourage any families affected by the policy to contact the ACLU-PA."
"We are constantly showing up in spaces, showing up in these meetings trying to push back against these policies," said Philadelphia transgender advocate Deja Alvarez.
Alvarez is concerned as more school districts pass similar policies some citing safety concerns. She says those safety concerns are unwarranted.
"The only harm that's done to people in the restrooms are harm to trans people," she said. "Trans people are not harming anyone in the restroom."
Still, Policy 720 received support in the meeting from some residents who spoke in favor of the plan and school board members who pushed the policy, which makes single-use restrooms available to transgender students.
There were also residents who spoke at the meeting against the policy.
"There are obviously some students in this school district that are uncomfortable that someone from the opposite sex would enter a locker room or bathroom," said Jayson Saylor, president of the Perkiomen Valley School Board.
Two of the school board members who opposed Policy 720 tried introducing their own policy which they said was a compromise.
It would have specified that students have to use the bathroom that aligns with their consistent gender identity.
The board, though, rejected that policy.