"I think what made it difficult for people to get, and still makes it difficult for people to get, is the theatrical nature of the work and the fact that, my music doesn't exist without the performance-art element"

Lady Gaga is referring to the trouble people have in understanding her music and efficiency art. She thinks that the theatrical nature of her work and the performance-art component are what make it challenging for people to comprehend. She is saying that her music does not exist without the performance-art aspect, which is an essential part of her work. This means that her music is not just about the sound, however also about the visuals and the performance. Lady Gaga is saying that her music is more than just the noise, but likewise about the efficiency and the visuals. She believes that this is what makes it difficult for individuals to comprehend her music and performance art. Lady Gaga is saying that her music is a combination of noise, visuals, and efficiency, and that this is what makes it hard for people to understand.