CONCORD, N.H. (AP) – The state Senate has joined the House in endorsing medicinal marijuana use by residents with crippling ailments.

The 14-10 Senate vote Wednesday sent the bill back to the House to review relatively minor changes. If the House endorses the changes and Gov. John Lynch signs the bill, New Hampshire would be the 14th state to legalize medicinal marijuana.

Also Wednesday, the Senate voted 13-11 to approve gay marriage and sent the bill back to the House to consider changes. If the bill becomes law, New Hampshire would become the fifth state to allow gay marriage.

The Senate’s bill establishes a clear distinction between civil and religious marriages, allowing religious denominations to decide whether they will conduct religious marriages for gay or lesbian couples. Civil marriages would be available to heterosexual and same-sex couples under the law. In March, the House rejected a similar, but less comprehensive attempt to create a distinction between civil and religious marriages.

Advocates of medicinal marijuana said the bill would show compassion to the severely ill. Opponents sided with police, who said the proposal would invite abuse and be difficult to regulate.

The governor also has sided with law enforcement but has not said he would veto the bill. He has said he’s open to allowing marijuana use in hospitals or hospices because they are contained, controlled environments, but current federal drug laws make such scenarios unlikely.

The bill would allow patients or their caregivers to grow and possess six marijuana plants and two ounces of the drug. Doctors would have to certify a patient has a debilitating medical condition and would benefit from using marijuana.

Only patients in constant pain, having seizures or severe, persistent muscle spasms or having severe nausea or vomiting and who aren’t helped by legal medications for at least three months would qualify for the drug.

The bill’s main sponsor, Rep. Evalyn Merrick, applauded the Senate action, suggesting the House will accept the Senate’s changes. The changes include a commission to study how patients would get marijuana and stronger privacy provisions.

Merrick, D-Lancaster, has said she has multiple myeloma, a type of blood cancer, and used marijuana to quell queasiness from chemotherapy in 2002.

The transgender rights bill would have protected transgender individuals under the state’s anti-discrimination law. The Senate voted 24-0 to kill it, but only after Democrats complained about how ugly earlier debate on the bill had been.

Republicans had called it the “bathroom bill” based on the argument it would have opened all bathrooms to men and women, potentially endangering children in women’s rooms.

Supporters said it was a straightforward anti-discrimination bill to protect vulnerable people who identify with the gender opposite of their birth.

According to the Transgender Law Policy Institute, 13 states and the District of Columbia have laws banning discrimination based on transgender status.

The Senate postponed final action on bills to require adults to wear seat belts and repeal the death penalty. Both could still be brought back before lawmakers adjourn in June, but Senate President Sylvia Larsen, D-Concord, said Wednesday neither had enough support to pass.

The Senate Judiciary Committee had proposed studying capital punishment instead of repealing the law. The House already has passed a separate bill proposing a similar study.

The House’s seat belt bill would make not buckling up a primary offense, which would allow police to stop vehicles solely if they notice an occupant not wearing a seat belt. The Senate rejected an amendment to water down the proposal by allowing police to give a seat belt ticket only after stopping a vehicle for another reason.

Supporters argued that seat belts save lives and the state bears the cost of caring for accident survivors who suffer lifelong disabilities.

The bill’s opponents said education, not a law, is the best way to get people to wear seat belts. They also argued New Hampshire’s long tradition of individual freedoms should be maintained.