Sure, you absolutely need a stateful firewall, but not needing address translation makes it easier to troubleshoot, makes it easier to establish end to end connectivity and no need to port forward or things of that nature so multiple clients can all use the same port.
* https://en.wikipedia.org/wiki/STUN
* https://en.wikipedia.org/wiki/Traversal_Using_Relays_around_...
* https://en.wikipedia.org/wiki/Interactive_Connectivity_Estab...
Not sure if that's more or less complicated than already knowing your IP address and 'just' using UPnP/PCP:
NAT isn't required in v6, it's not wanted in v6, but it's perfectly possible. If you think about it, PAT/NAT (port-based NAT) doesn't happen at the IP stack, it happens at the port level.