Struggling with router SIP traffic. (pfsense)

Assuming that you are using registration for your Telnux trunks, disable source port rewriting; see

and set the firewall optimization to conservative.

If using IP auth, allow all addresses from which Telnyx can send calls in Match (Permit) and firewall rules: Whitelisting Telnyx IP Addresses | Telnyx Support.

If you still have trouble, consider using SIP over TLS to prevent the firewall from messing with the packets.