Feeling for you. I am also very torn about where I live, and the list of pros/cons seems endless at times.
I live in northern Virginia, 5 miles outside of DC. I work in the city and drive in everyday. I do have a strong preference for the suburbs here to the actual city, and having lived on the Maryland side, I can say that Virginia is a much better fit for me personality-wise and politically.
But the cost of living is insane. We consistently make those top 10 lists for most expensive places to live in America. Most people think nothing of putting an entire paycheck (or more) towards rent. For the price of one house in a good neighborhood here, I could buy an entire block of houses in the Midwest. Traffic during rush hour is terrible. Public transit is not as good as other major metro areas. The majority of people I randomly encounter are only interested in what you do and who you work for - if it isn't interesting or well known, you are by default seen as not interesting.
But the perks are seemingly endless. Anything I could possibly want is within a five mile radius of my house. I can walk to the grocery store. There is a park at the end of my block. Many things are open 24 hours a day. There are great state parks and places to visit. Most of the museums in the city worth going to are free. DC has several trans protections on the books, and it is exceedingly easy to get proper healthcare there. There are so many government agencies and contractors here, if you're well qualified you shouldn't have a problem finding work.
For many years I've wanted to go to the Pacific Northwest. It seems to take all of my favorite perks of here while removing many of my biggest issues with the area. But a cross country move is expensive, and it's difficult to secure a job so far away unless you have a connection. I know there are several resources for healthcare there, though I would be nervous about leaving my current doctor.
It's a toss up. My approach has been applying for jobs at national companies, with hopes that I could start in their DC offices and potentially move elsewhere in a few years.