There are for sure way fewer bars, but the few that are here are always packed on weekends. The scene is also less centralized, so I don't think I meet as many LGBTQ people randomly as I would in say SF.
On the other hand, I would say that a good percentage of my friends are LGBTQ. I also my met my husband here, gone to our Pride events many times, have seen a bunch of live drag, and generally feel comfortable being out.
If someone's thinking of moving to a smaller city and the perceived lack of gay culture was the only thing holding them back, I would say just go for it.
(An actually rural area along the lines of my old college town is another matter. Driving half an hour on freeways to get "anywhere" is intolerable in a way that bicycling through Nature for half an hour is not.)
So yeah, between one thing and another, there would need to be a pretty strong incentive for me to ever move to "the burbs" or "the middle". Give me a city, give me a village or kibbutz, but don't give me that rubbish people put in the middle!