There are a few hills that require herculean effort to ride up in my area. There are a few hills that require me to use the bailout gear to get up (leftfoot/rightfoot).

It's generally not a big deal. Any hill that you can't ride up on a reasonably geared fixed gear is going to be a monster hill to a geared bike too. So you're either walking your fixed gear up the hill like it's a dog, or you're spinning your super-low gears like a gerbil.