Honestly I don't think it was dramatically worse than any other rural area I've lived in. They all suffer from basically the same issues- poor infrastructure, poor access to care, difficulty in attracting applicants to most competitive healthcare roles (including MDs and DOs), underfunded, etc. I've lived in Western MA and Boston (never central MA) and Western MA may as well be a completely different state.

Other commenters have noted the Berkshires have less access but when I lived there quality seemed to be a concern too. We used to call it Berkshire Murder Center...but it's been a long time so I have no idea if it holds true today.

I would not recommend Boston proper if you can afford to go elsewhere - Cambridge and Somerville will definitely be the places with the strongest sense of community. On the whole as an LGBT person I feel incredibly safe in the greater Boston area.

That being said I can't predict the future. Eastern MA does have some suburbs where you won't be as comfortable or welcome.

Is moving here a good idea outside of the LGBT legal protections? Tough to say. We're having a massive cost of living crisis right now same as many other places.

I love it here. I pay way too much to live here - but I consider that an acceptable tradeoff, because I love it here.

I for one welcome our non-existent overlords

edit: that didn't last very long!

maybe if you had a sales tax you could afford more state park amenities