Only when the endpoint nodes are both Starlink customers. Otherwise there will be a gateway at at least one endpoint and a number of hops after that.

I'm quite curious to see what their antenna setup looks like in practice that's going to be an engineering marvel.

Indeed. These satellites move which means the antenna dishes have to do so as well. Or they'll use phased arrays, and phased arrays are not consumer-cheap (yet).

From what I've heard, the consumer end gear supposed to use phased arrays "about the size of a pizza box" and cost in the range of $100-$300.

Aren’t TV satellites something like 5000-30000km away? 200km sounds easy.

Those are geostationary, these are not. So that's 'easy' as in 'a mere matter of engineering'. You will either have to track the satellite mechanically or by 'beam steering' aka phased arrays. Neither of those are trivial technology wise.

any Idea how big one of these antennas needs to be? Could you mount it on a gimbal similar to a DJI is mom and just have it aim automatically where the signal is strongest?