Social workers in Texas can turn away people with disabilities as well as LGBTQ people after a "cowardly" decision spurred on by the state's Republican governor.
The Equality Texas advocacy organisation said the Texas social work licensing board had stripped "explicit protections" that prevented discrimination on the grounds of disability or sexual orientation.
"This is cruel, cowardly politics at its worst," said Texas Freedom Network president Kathy Miller.
"Discrimination is shameful, even more so when you try to hide what you're doing."
The board in charge of social work licensing in Texas unanimously approved the policy change after a recommendation from Republican governor Greg Abbott.
Equality Texas chief executive Ricardo Martinez said LGBTQ people and people with disabilities could now face higher obstacles when looking for help.
"The social workers code of conduct previously helped ensure ethical treatment of all clients and prevented bias-motivated misconduct," he said.
"Now with the removal of sexual orientation, gender identity and gender expression from the code, LGBTQ+ folks who experience discrimination could face more obstacles to getting the help they need."
Equality Texas said the change had been voted on without public comment.
National Association of Social Workers spokesman Will Francis said social workers still had a professional obligation to avoid discrimination.
"Social workers already have the ability to decline to provide services to a client based on their competencies and training, but they cannot discriminate based on selective personal values," he said in a statement.
"The language in the Code of Conduct was taken directly from the social work Code of Ethics, which was developed in 1960 and serves as the standard bearer for defining the values and principles that guide social workers’ conduct in all practice areas."