I live in West Virginia and the TG support group I go to is in western Maryland. Several members come from even further western MD, which is mountainous. OK hilly (2,000 ft) by Rocky Mountain standards. Nevertheless, MD has trans protection law in place and western MD which is hilly has trans folks.
If you got a map handy, look in the panhandle area along the I-68 and I-70 corridor from Frostburg to like Gaithersberg in the east.