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RALEIGH (AP) — State Sen. Jim Forrester, a physician and social conservative who secured a legislative victory just weeks ago with a constitutional referendum next spring on whether to ban gay marriage, died Monday after a brief hospitalization, according to his daughter. He was 74.

Mary Paige Forrester said the Gaston County Republican died at Gastonia Memorial Hospital in Gastonia shortly after being taken off life support late this morning. Forrester had been in declining health this year. His condition took a turn for the worse over the weekend while visiting the mountains to watch the leaves turn, according to his sister-in-law, Sally Beach. Although Forrester had been hospitalized previously this year, he was at the Legislative Building just last Thursday, using a cane to walk slowly to a government oversight committee.

"He passed very peacefully," his daughter said. The 20-year Senate veteran was surrounded by family members when he died, she said.

Forrester, a family practitioner from Mount Holly and former Air Force one-star general, first joined the Senate in 1991 and often worked on health issues. He most recently represented Lincoln County and parts of Gaston and Iredell counties.

He served briefly as Senate minority leader in 2004, replacing then-Sen. Patrick Ballantine when he resigned to run for governor. In January, Forrester became deputy Senate leader — a largely ceremonial post — when Republicans took over the chamber for the first time in more than a century.

"Jim was a dear friend who I respected and admired," state Republican Party Chairman Robin Hayes, a former General Assembly member, said in a statement. "He had a long and distinguished career serving the people of North Carolina."

Forrester was best known in recent years for regularly filing a bill that would allow voters to decide whether to add a gay marriage ban to the state constitution. Democrats in charge of the Legislature blocked debate and votes on the measure, pointing out that state law already limited marriage to a man and a woman.

The question was approved by the Legislature in September, after elections last fall in which Republicans took over both chambers of the Legislature for the first time since 1870. The referendum, which would make traditional marriage the only domestic legal union recognized by the state, will be on the statewide ballot in May.

"If people reject it and say, 'No, we don't want this in the constitution,' then I'll live with it," Forrester said just after the final legislative vote in September. He said the bill wasn't designed to single out gays and lesbians: "It was just something I thought we needed to do to continue to have a strong family structure here in North Carolina."

Usually known for a mild demeanor, Forrester became a nemesis of the gay-rights movement recently for his pointed comments about the gay community and politics. Last year, he apologized for saying at a local GOP event that "slick city lawyers and homosexual lobbies and African-American lobbies are running Raleigh," a reference to state government.

One gay-rights group said Forrester was trying to promote a "disgraceful form of bigotry" and was "mean spirited." ''He is determined to stomp every gay person into the ground," Faith in America founder Mitchell Gold was quoted as saying in a group web posting in February.

Shortly before the September referendum debate, Forrester called gay-friendly Asheville a "cesspool of sin." He said later he was referring in part to a rally at which women went topless.

Forrester adjusted his resume this fall when his membership status in various medical organizations was questioned by gay rights activists. He said he was being unfairly targeted.

"The gay and lesbian community is trying to discredit me," Forrester said Sept. 30. "I'm not trying to deceive anybody."

Forrester was born in Scotland but moved to the U.S. as a toddler and graduated from New Hanover High School in 1954. He was an Air Force surgeon and had served in the North Carolina Air National Guard, according to his website.

Survivors include his wife, Mary Frances, a Republican activist in her own right; four children; and several grandchildren.

No funeral arrangements had been made as of Monday afternoon.