This document discusses possible man-in-the-middle attacks when a back-to-back user agent (B2BUA) is involved in a SIP call. It outlines three modes of B2BUAs - media relay, media aware, and media terminator - and the associated risks. It proposes mitigations like mandatory authenticated identity management to prevent attacks when the B2BUA modifies signaling or media. The goal is to maintain end-to-end security between the original endpoints while allowing flexibility for B2BUAs.