From what I recall after reading the book years ago, Yanagihara is gifted at writing prose but ultimately her characters fall flat & events in the book serve no real purpose. People in the Trees has a similar issue (mainly the way she has p*do content in there mainly for the shock factor)
Essentially it’s a book that’s completely just queer trauma/torture porn written by a cis straight woman. It’s about several gay men suffering endlessly throughout their lives in graphic and unnecessary detail. It’s to a point where it’s just homophobic and exploitative. And yet just because it’s written well people rush to defend the book as if the author’s paying them