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.