NASHVILLE (AP) — Therapists and counselors in Tennessee could decline to treat patients on the basis of "sincerely held religious beliefs" under a bill passed by the state Senate on Wednesday.

Opponents argued that counselors shouldn't be allowed to deny treatment of people in crisis because they are gay, transgender or practice a different religion. But the chamber ultimately voted 27-5 in favor of the bill sponsored by Republican Sen. Jack Johnson of Franklin, who said it is aimed at being able to refer patients to "people who specialize in this."

The bill is part of a wave of state legislative proposals to allow clergy, businesses or state officials to refuse certain services to certain people based on religious views, an after-effect of the Supreme Court's ruling on gay marriage.

It's not the first time state lawmakers have tried to take a stand on counseling issues. A proposal to make Colorado the fifth state to ban gay-conversion therapy failed last year, and a renewed effort this year faces strong opposition from Republicans.

Jennifer Pizer, a senior attorney for the gay rights group Lambda Legal, said that while proposals targeting counseling rules have cropped up in other states, Tennessee may be first to have it pass a legislative chamber.

"This kind of a bill confuses pastoral counseling with mental health care," Pizer said in a phone interview from Los Angeles. "The reason mental health professionals are licensed and held to professional standards is to protect patients who are seeking mental health care and not seeking pastoral or religious counseling."

Sen. Steve Dickerson of Nashville, a doctor and the lone Republican to vote against the bill, said he would never refuse treatment to anyone.

"When you choose to go into the healing arts, you give up a certain amount of latitude," Dickerson said. "If you choose to become a counselor or choose to become a doctor, you treat whoever comes through your door."

But fellow Republican Sen. Mark Green of Clarksville, another physician, said that he regularly refers patients seeking birth control to another doctor.

"I am allowed to refer that patient to another provider and not prescribe the morning-after pill based on my religious beliefs," Green said. "This amendment allows another medical profession — therapists and psychologists and psychiatrists — to do the same thing."

Republican Rep. Joey Hensley, another physician from Hohenwald, said having counselors refer clients to other professionals makes sense if "they believe that that patient's lifestyle is causing their problem."

Johnson, the bill's sponsor, said the legislation is an effort to overturn a 2014 change in the American Counseling Association's code of ethics that says counselors should "refrain from referring prospective and current clients based solely on the counselor's personally held values, attitudes, beliefs, and behaviors."

"I'm not aware of a problem that existed prior to the amended code of ethics in 2014," Johnson said. "All we're doing is reverting to that code of ethics. It seemed to work very well for many, many years."

The House version is scheduled for a subcommittee vote next week.

___