Thirty men aged 17-48 years with pure 47,XXY Klinefelter syndrome have been studied. The group was a positive selection diagnosed not on account of behavior problems but infertility or hypogonadism. Interviews and additional information revealed, almost without exception, the characteristic personality traits of XXY patients. At school, problems arose early, particularly in relation to language. Routine administrative acts such as 15 class repetitions had predominantly negative effects, thus increasing the patients' tendency towards social isolation. In manually oriented professions the patients were quite successful, but in apprenticeship several had to drop out due to problems in theoretical courses, especially foreign languages and mathematics. The diagnosis could nearly always have been suspected by pediatricians, school doctors or school psychologists when the patients were aged 4-8. Early diagnosis is crucial for counseling of parents and teachers, for vocational guidance and for timely testosterone replacement therapy. Patients, and their parents, could thus be spared much unnecessary suffering.
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