seems like it would have been a hassle to deal with for the last 15 years
Of course, I've configured my server to properly sign email, publish SPF records, and so on. My server may be small, but god damn it, it's top notch.
I agree that outgoing deliverability isn't really a problem for me either. I do have DKIM and SPF set up. I also am a fairly low-volume message source. I think self-hosting is more tricky if you're emitting large volumes of mail, like transactional emails for a business. But as a personal email server it's been fine for me.