The dissonance is here:

A longtime Republican herself, A.W. says she never would have believed her family would need this help. “But we do need it,” she says. “We need it really badly right now because my husband is still unemployed.”
She says she knew the rule restricting access to transgender care through Medicaid was coming, since it was proposed in December. Still, when it was published, she felt panicked. “The initial just — what are we going to do?”

The article doesn’t mention 1) if she voted for trump 2) or his transphobic policies. I am not so sure what else is there to go by, that she “chose a leopard to eat her face.”