Health-LiveI am in the hospital with my wife of 10 years who has just gotten her gender reassignment surgery. AMA!
Mar 22nd 2017 by ashmonster • 42 Questions • 7327 Points
I am a federal budget analyst. My focus is macro fiscal policy, including the main drivers of spending and revenue, deficits, and debt. I am happy to talk about the Trump skinny budget, and I am happy to talk about the American Health Care Act, though I'm not a health policy expert. The opinions expressed here are my own and do not reflect those of my place of employment.
Thanks for the great response. Why don't we (the government or people who can) close the fiscal gap then?
Actually, no! I identify as bisexual with a female bias, so it works really well for me.
I just realized I didn't give a good enough answer on this. Sorry about that. The reason we don't is that we can't agree, and there's still a long way to go to get there. Republicans don't want to do tax increases. Democrats don't want to do significant cuts to Social Security, Medicare, or Medicaid (the parts that are actually growing). So, that leaves us at a longer-term impasse.
But, all the stuff I said about the progress is still true.
So did thisisnotmyjob know she wanted to become a woman when you two met, or did that come later? In other words, did this start out as a homo- or heterosexual relationship?
Isn't LIHEAP proposed for either drastic reductions or total elimination every year?
She knew since she was about 6 years old that she wasn't comfortable in a male body. When we met, she told me about it and she started hormones shortly after. To be honest, our relationship hasn't ever been homosexual in nature, since she's always been uncomfortable with her male parts. We haven't actually had sex yet.
Obama's final year called for a reduction, but his first years called for large increases. Bush 43's first budget called for an 18% reduction. That's pretty drastic, but not in the realm of complete elimination. Budgets before FY1996 are not online, and Bush 41 and Reagan were before my time, so I couldn't answer that.
What are some of the reactions you've gotten from people regarding your situation?
What's a step that Americans on both sides of the aisle would agree to that would help balance the budget?
Mostly positive! When she came out of work we were really surprised at how wonderful most everyone was about it. There have been some people who can't adjust to the change, they tend to avoid her. One or two keep using her dead name intentionally. But there hasn't been any outright hostility, thankfully.
Strangers for the most part either just assume automatically that she's a girl or they get confused.
Great question. The answer is that most of the low-hanging fruit is used in deals. There just aren't trillions of dollars for things that each side says is fine. In order to get to a place, one side needs to have the ability to exert its will, or each side needs to be willing to do stuff it doesn't like. One of the biggest issues with growing polarization is that agreeing to the stuff you don't like is a much bigger deal. Bush 41 increased taxes. When's that happening again? For the Joint Select Committee of Deficit Reduction, Paul Ryan was one of the Republicans appointed. Not a chance in the world that he was going to accept big tax increases. Chris Van Hollen was there on the other side. Not a chance he was going to go for major Medicaid cuts.
How was your experience of being married with u/thisisnotmyjob during her transition?
Exactly. If your figures are correct myself and many liberals have been duped. I'm way less attached to being right than the truth. I'm so sick of the twisted misinformation.
A rollercoaster, but not a scary one. When she first started on hormones, she was an emotional mess for quite some time. As she continued through her transition, it was a challenge to help her keep an optimistic viewpoint about her future and especially to encourage her to be comfortable with her body as it changed. It took a while for her to go out in public presenting as female. Sometimes it took a lot of white lies.
There has been some sexual tension, but not much. Though we haven't had actual sex, we have fun however we can and are very intimate. It's a huge weight lifted for me now that she's had the surgery. I'm almost beside myself because in just a few months we can finally be together in the closest way possible.
Aside from the physical changes, the hormones have really affected her personality. She's still the same goofball but she's more outgoing and less shy. But her anxiety levels have taken off, and it has been the hardest part to adjust to, because I really don't understand it. I think though that the surgery will greatly improve that.
The figures I linked to are correct. The image you see floating around is from the National Priorities Project. The percentages are correct, but they represent funding for only what's called the "discretionary" part of the budget - that which Congress actively debates each year through the annual appropriations process, rather than programs where the funding has already been agreed upon. The discretionary part of the budget is only about one-third of all spending.
The two categories are discretionary and mandatory. On the mandatory side is Social Security, Medicare, Medicaid, Food Stamps (that's another thing typically wrong the graph - it mentions food stamps, but it shows something hitting WIC), school lunches, unemployment insurance, some retirement things, and whatnot. On the discretionary side is most of what we think about when we think of government programs. It's WIC. It's Section 8. It's NASA. It's NIH. It's the National Science Foundation. It's funding the arts and humanities. It's all the tiny things that get a little big of government help. And, because of Article I, Section 8, Clause 12 of the Constitution, that's where our military budget lives. The founders were very wary of standing armies, but of course it doesn't make sense to have a non-professional army.
At any rate, it is correct that the military is over half of what Congress approves every year, but I consider it deeply misleading, and I mention it whenever I see my friends share that graph on Facebook. It's true that we aren't debating Social Security and Medicare, and so the military is getting half of what we're debating, but the whole question is "what does XX say about our priorities," and current spending on mandatory programs need to be part of that question.
I similarly don't like the statistic "we're spending more than the next XX countries combined!" Yeah, well, we're also bigger than the next XX countries combined. That would be like complaining that California is spending more on police than all of New England combined. Yeah, well, its economy is bigger than all of New England combined. The reason we're spending too much is not because of what France is doing. It's because we don't need to be ready to go to war with the entire world at a moment's notice. It's because the threats we face are not the kinds that would require major troop mobilization. So, don't get me wrong - I still think 16% is huge. I think spending 1/6 of your dollars on the military is a lot. But it's not half.
In general, if something feels crazy, you should see what a few fact checkers have to say. It might be true. Some really crazy things are true. But some have been slightly twisted.
How much of an element of voice therapy was there to the process and how much did she value that as part of her transition?
Exactly. If your figures are correct myself and many liberals have been duped. I'm way less attached to being right than the truth. I'm so sick of the twisted misinformation.
We've done a few sessions with a speech therapist but ran out of the funds for it. It is very important to her, though, and we will either continue with the speech therapy or get her vocal feminization surgery if that isn't enough.
This is all to say that there's currently a budget for travel and for protection, and it's not difficult to move around money to make it work. I promise you that this money was appropriated.
Do you ever get/feel negative stigma from family or friends? I know that can somewhat be controversial to some people. (P.S. I think its awesome you two found eachother and are happy! Love is love man)
What is your personal opinion of the Trump budget, as presented yesterday?
E: added "personal"
Her mother took a long time to adjust to the change, and she's had other family members who cut her off completely. But for the most part her family, especially her brothers and father, has been very supportive and understanding.
My parents, though they're lesbians, also took some time to adjust to the change. They still sometimes accidentally use her dead name. I think it's more of a generational thing than purposeful ignorance; they're just not used to transgender people. My sister though has been incredibly supportive.
I don't like it's priorities. We currently spend about 16% of our money on our military, and I don't think we need to spend more than that. If we want to spend more money on military, I don't think it should be at the expense of programs that keep people out of poverty.
That said, this was a very incomplete document. We'll get a lot more information in the bigger budget in May, and so we'll get a better sense of his priorities, which may look different by then.
Did the hormone therapy really throw her for a loop? What is the recovery time after surgery? What are the legal challenges of the change since you are already married?
BTW, y'all look happy!
Thanks for the reply!
Yes, definitely. Aside from the emotional wreck that she was when she started, it's really changed the way that she cogitates. She says it's more of an instinctual/emotional thought process instead of thinking more logically. She says "I still think of the shortest most logical path to a solution but now I'm also thinking more about the long-term effects. I'm also far less spacially aware. I used to get to level 12 on Tetris; now I can barely make it past level 6."
In the hospital for 4 days, then four weeks of home recovery which includes doctors visits and dilation and other things.
Thankfully, since we're in California, the domestic partnership that we have is still in effect even after she got her name and gender legally changed. We are getting officially married at the end of this year (she wanted to wait till she was legally a woman).
Sure - hope you found it useful!
1.) Considering what kinds of replies you imaginably might get, how much deliberation did the two of you put behind deciding to open up such personal parts of your lives to strangers on the internet?
2.) What was your intention/goal? And do you think you're achieving it?
3.) Congrats :) And thanks for sacrificing your privacy to educate many who wouldn't otherwise look. :D
I did. Just yesterday I was wondering what sorts of things budget analysts think when reading such an unusual budget. Turns out, in this case anyway, at least one of them thinks more or less what I thought (with far less swearing!).
Weirdly enough, she was looking forward to doing an AmA after the surgery. She used to be very reserved about being transgender and didn't want people to know, but in the last year or so she's gotten more comfortable with the idea. She also said that she thinks it's very important to get more information out there and answer questions so people can be more accepting of transgender people.
The goal for her was for her outward appearance to match how she feels on the inside, so I think we're set :)
Thank you! Education is very important when it comes to these issues.
Haha, well, this is my measured response the day after. Yesterday was a very long day with a lot of unhappiness. There are a lot of things I'm willing to compromise on. Food, shelter, and heating are not among them.
10 years of no sexual activity at all?
EDIT: I wrote this 4 hours ago. she had not stated that she had been raped until after I had posted this.
So is my impression correct that the GOP and WH are trying to sell this budget in terms of the 'trickle down' theory that tax cuts for the richest will result in job creation?
I wouldn't say no sexual activity, just no penetration. We are still intimate in other ways.
We'll have a better answer to that when we see the bigger budget likely in May. This budget only had discretionary spending (about 1/3 of the budget), and it didn't have any tax policy.
That being said, President Trump has been pretty explicit about the fact that he believes his policies will lead to higher growth, which is the concept being supply-side economics - that there will be a change in the underlying supply of labor in response to changes in tax policy. His tax cuts he proposed on the campaign reflected that. So probably, but we will have to wait to be certain.
Republicans have preached that reducing taxes will boost the economy and net tax revenue will remain the same. In you experience and analysis, have you found this to be true?
Stealing from an answer in another place, the concept behind supply-side economics is that taxes are so high, that they disincentive work, and so, while cutting them loses revenue, it gains back at least some from increased work.
So, if your taxes are cut, you earn a little bit more per hour worked, so you might work more. But, on the flip side, you might decide that you can actually work less to get the same income, so you might work less. That's the concept, and the question is behind the income effect and the substitution effect.
It's tough because most people can't dial up or down their work. I have a salaried job. I can't go to my boss and say, "Hey, I'd like to work 5% more hours, so please pay me 5% more."
At some level, this is certainly true. If you went from 100% taxation to 90% taxation, you'd probably get more work. But from 39.6% to 35%? That's less clear, and there isn't evidence to support it. We certainly didn't have kick-ass growth during the Bush 43 era, and we certainly lost a lot of revenues. It might very well have been true for Kennedy going down to 70 percent. But that top tax rate was hitting so few people, it's hard to imagine it really had a large change. Again, it depends how many people are being affected, how much their incentives are changing, how much they're able to change their work, and how much they actually do.
Reagan's own budget group, in his final year, estimated that his first round of tax cuts cut revenues by 26%. Subsequently, he raised taxes by 14%, relative to that new base.
In truth, labor is not being supplied by prime-age folks at the rate we would expect, and it's unclear why. I don't believe it's exorbitant benefits because Europe does better than we do. Here's a very long report on the decline in prime-aged male workers: https://obamawhitehouse.archives.gov/sites/default/files/page/files/20160620_cea_primeage_male_lfp.pdf
I have now cringed so hard that I think I sucked up part of my office chair cushion into my ass.
Wow, that was much to read and I still contend that the author does not understand what happens in the shadow economy as he calls it. How does he count the legal immigrant that collects the check and distributes cash to the five undocumented immigrants that work under him. How does he count the crews I compete against for construction work that are completely off the books. Do you think the guys in the hood answered his survey honestly?
I have really enjoyed your explanations of fiscal policy. Thanks!
Yeah, without going into the gory details, the glans and other sensitive parts of the penis become donor material for the reconstruction. It's a really fascinating process.
I'm glad you read it! That's a great point, and I couldn't tell you. All I know is that the government uses advanced statistical methodology to try to estimate and account for non-response bias, but we obviously can't tell. There's frequently no natural experiment to see how well the methods did.
I couldn't really expound beyond this because this isn't my area - I just know that the author, Jason Furman, is incredibly highly respected (and Matt Damon's freshman year roommate in undergrad) and is a person who does all he can to make sure he's not biasing data through omission.
Thanks! I'm glad you enjoyed it!
How would you incentivize the private sector to invest more in job training, like Trump seems to want. And do you think Trump will do what needs to be done to make this happen?
Businesses try to maximize the net present value of their profit, discounted to infinity (or at least the life of the current heads of the company). That is, they try to get as much profit over the period they care about. Currently, they do job training if they think it's helpful/if they need to (because there's a supply shortage, as during the dot com boom, rather than a demand shortage). A government policy that focused on that would be in changing the profit margins and thus the incentives for them. But we already let companies write off training and salaries as a business expense, so that's not it. We could pay them to do it! But then why not directly do it? The government actually has plenty of jobs training programs. Unfortunately, Trump's budget proposed to cut some of them. So, I'd be surprised, but you never know. We'll get more detail about all of his priorities in the bigger budget in May, which will go line by line through every account in the federal budget.
Happy to clear that up - sorry I skipped too many words before!
Wow, thank you for the detailed answer. Even if I don't enter economics as a career, I think I'll always be interested in these kinds of issues. I've heard often about how military spending is too big, but I don't think I've ever heard about arguments for the other side beyond "cause 'murica," so these insights are helpful!
Well, for what it's worth, I think that if you're at the point of defending a government program based solely on the job it creates employing, you're losing the argument. But that's a real thing, and that's part of the real political difficulty in cutting anything, but particularly the military (because members of the military are not viewed as simple bureaucrats).
It's just to say that there's no cut that doesn't have an immediate impact on real human beings.
I did not mean to dissuade you from economics, and I'm sorry if it came off that way. I frequently wish I had more of a background in economics and often consider doing a one-year Masters in Economics program. I just meant to say that it's difficult and sometimes quite competitive.
Since we have a debt based currency, over the long run will we have to continually grow the debt to sustain the currency?
I'm sorry, I wish I knew more about monetary policy, but I really don't. But from what I know, I don't believe that should be the case among other things because we also control our own monetary supply, and our debt is in our own currency, which is also the world reserve currency. But I'm pretty outside my area on monetary supply.
Solar, exactly. But most of our economy is based on Oil. We were head in the right direction. And since Trumps new budget completely guts the NASA budget, I don't think we'll even research the mining technology let alone fund a mission.
Sure, yeah. I should have made two separate points. First, I think we can keep growing because of other resources. The reason we weren't growing for thousands of years is that we weren't really accumulating stuff. We were just living.
Second, though, just living at current levels is way better than just living in poverty. That is, I'm not convinced that growth itself is the party. I think having sweet things is the party.