The counselor can't have it both ways: that she gets to be a bigot AND gets to hide behind the claim of "I was acting in the best interests of the client" (AND on top of that then gets to claim "religious discrimination" when the government refuses to embrace her contradictory positions).

As a counselor, her contact with her clients requires a special level of understanding above what a county clerk would need. Whereas the latter merely needs to stamp forms without any regard to the uniqueness of the individuals, the former must interact intimately with her clients. If she truly feels that she is unable to perform her services adequately for a gay client, I would assert that she has the professional obligation to refer the client to another counselor who can. To do otherwise would not only force the therapist into occupational conscription (I believe this is also your objection to socialized medicine), but also subject the client to substandard care.

The issue comes, as you have pointed out, with this particular counselor working on taxpayer funds rather than privately. Certainly a private individual should be permitted to selectively refuse potential clients. But I would argue that while this counselor is obligated to provide some service as a result of her status (be it a referral to a reasonable replacement, or service in a diminished capacity if no such replacement is available), she is not required to indiscriminately service clients with needs outside of her professional understanding.

This distinction may be very fine — or perhaps even illusory — but I believe refusing a client on the basis of inability to deal with the individual's problem (not discriminatory) is different than refusing a client on the basis of bigotry toward the individual (discriminatory).

In my view, a therapist may refuse to perform services for gay and lesbian individuals if he or she believes him or herself unable to provide a quality level of service and if a suitable replacement exists. Her status as a taxpayer-funded employee will make her subject to stricter scrutiny, of course, but I still believe that she did the professionally responsible thing in referring a client to a practitioner more capable of dealing with her problems. It is not, after all, as if she outright denied service in the way that some California county clerks have attempted.