I ran across this and figured if anyone has a PFSense firewall they are trying to use with VoIP trunks they may have need of the following.
TLDR: PFSense update version 25.11.1 broke SIP. The fix is:
System > Advanced > Networking - then scroll down and check the box to “Disable hardware checksum offload.” Then save and reboot the box.
Also a possible fix reported to work:
System → Advanced → Firewall & NAT and changing the Firewall Optimization Options to Conservative
See the following:
Did anybody have VOIP issues after upgrading from 25.07.1 to 25.11.1? : r/PFSENSE