‘Like Living Life in a Constant State of Mind Panic’: A Mixed Methods Exploration of Living with and Overcoming Everyday Executive Functioning Challenges in Adults With Klinefelter Syndrome/XXY

Objective XXY, or Klinefelter Syndrome (KS), is a common chromosomal variation impacting neuropsychological development, including executive function (EF). This study explored everyday EF challenges, experiences in cognitively demanding contexts, and how individuals overcome difficulties. Method Eighty-two adults (aged 19–81; M = 48.00, SD = 15.28) with KS/XXY completed a mixed-methods online survey including the Executive Skills Questionnaire, and Occupational Self-Efficacy Scale. Open questions asked about strengths and challenges with EF, EF-related experiences in education and employment, and the ways they overcome challenges. Results EF difficulties ranged from minimal to severe, with 75% reporting frequent challenges in at least one domain. Challenges were more common in organisation and time management than other areas, higher in those unemployed than those employed, and inversely related to occupational self-efficacy among employed individuals. Themes highlighted the nature of cognitive and interpersonal challenges, emotional and practical consequences, and mixed success with compensatory aids and interpersonal support. Conclusions While EF challenges are not universal in KS/XXY, their impacts on everyday functioning, particularly in cognitively demanding settings, can be severe. Many struggle to find effective solutions, emphasising the importance of identifying effective support approaches in future research and practice.