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Assuming at least one side isn't under a NAT, true. Otherwise it gets... "fun".

Why would you be under a NAT? A public IP and a networking allotment is one of the core offerings of almost every cloud provider out there.

A NAT does not stop you if you do it right. Console games have been hosting servers through NATs for the last decade.

As I said: it gets "fun", especially if you want to do it without a third server to set up the connection. Still doable, just "fun".

I would speculate that the massive advertising revenue generated by the 'bay probably renders any such 'fun' factor trivial.