All these are cases where the male genetalia would already be present from birth. which would require surgical intervention.
and that's without getting into the complexity of the effects of androgen in utero.
The syndrome's cause, an extra sex chromosome,....For this reason, the term "Klinefelter syndrome" has fallen out of favor with medical researchers. Most prefer to describe men and boys having the extra chromosome as "XXY males." the syndrome itself-the set of symptoms and characteristics that may result from having the extra chromosome-is uncommon....... Many men live out their lives without ever even suspecting that they have an additional chromosome. " I NEVER refer to newborn babies as having Klinefelter's, because they don't have a syndrome,....." said Arthur Robinson, M.D., a pediatrician at the University of Colorado Medical School in Denver and the director of the NICHD-sponsored study of XXY males...... "Presumably, some of them will grow up to develop the syndrome Dr. Klinefelter described, but a lot of them won't." In addition to occasional breast enlargement, lack of facial and body hair, and a rounded body type, XXY males are more likely than other males to be overweight, and tend to be taller than their fathers and brothers. For the most part,.... these symptoms are treatable..... Surgery, when necessary, can reduce breast size. Regular injections of the male hormone testosterone, beginning at puberty, can promote strength and facial hair growth-as well as bring about a more muscular body type. A far more serious symptom, however, is one that is not always readily apparent. Although they are not mentally retarded, most XXY males have some degree of language impairment. As children, they often learn to speak much later than do other children and may have difficulty learning to read and write. And while they eventually do learn to speak and converse normally, the majority tend to have some degree of difficulty with language throughout their lives.... If untreated, this language impairment can lead to school failure and its attendant loss of self esteem.
http://my.clevelandclinic.org/disorders/klinefelter_syndrome/hic_understanding_klinefelter_syndrome_a_guide_for_xxy_males_and_their_families.aspx