I have known from the transistor level through to the mouse moving on the screen, just not all at once. If I put the effort in then I know I could have a solid grasp of all stages at once but it would be a waste. If you're programming in assembly then you're dealing with instruction sets. You don't need to know how transistors make up a NAND gate to program with instructions, or even how gates fit together to make higher order components. You just need to need you have a processor and memory.