It isn't Portland or Seattle or San Francisco but it isn't as bad as you might expect (based on what I hear from LGBT friends and my observations). There's a tradition of leaving people to do their thing. We have a democrat governor. Probably best to keep to the left half of the state though. The college towns and tech firms are in the western half.

Usually if you don't be a dick (if you have one or not) nobody cares. Missoula would be the best town if you're looking for an inclusive city culturally. Our state pride is pretty big. https://www.bigskypride.com

I'm outside of Missoula. There are a few trans people on the reddit and I've heard adds for clinics offering care on the radio.

Generally Montanas seem to have a "you mind my business and I'll mind mine" attitude. So while there is a large right wing component they seem to be mobilized more by gun rights and logging/mining jobs then being anti gay/trans.

Our rural county did stop taking federal money for the women's health clinic as a tea party grand stand which is unfortunate.