I really liked the twists and turns in this book. It ended a little weaker than it started, but it wasn't by any means a bad ending, and very much fit the themes of the book.
The book doesn't hang together like a regular book, but I'm a little confused by the folks saying it doesn't make sense. It seems like you'd have to miss the whole premise for that to be your reaction. You don't have to like the premise - this is a weird book and certainly not for everyone - but that's different from saying the shifts in perspective were nonsensical.
A vagina is not a vulva, and that was a glaringly poorly written scene.
I had a lot of fun reading this book.