NASHVILLE, Tenn. — 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 last week.

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 on Feb. 17 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.”