The Toolbar in the compose window of the Mail app is not detected by VoiceOver

1. Create a new email message or reply to an email as you normally would.
2. After composing your message, to attach a file, press space with 3-6-7-8, VO Shift M, or perform a 1 finger triple tap on the touchscreen while still in the message.
3. After a short delay, a menu will come up, with the first option being "paste".
4. Navigate to "forward" and activate this.
5. continue scrolling until you find "attach file"
6. The workflow will now proceed as it used to.
Alternatively, I'd suggest using Outlook for iOS which still allows this without a multi-step process. You can also use the Files app or other apps to access content and then utilize the sharesheet. For example, using Files, you can navigate to the fie you wish to attach and then select share, followed by mail. You can access the Writing Tools by finding them in the "edit" rotor or by using the process outlined above and choosing them instead of "atach file". These workarounds are why it does not have a higher severity rating.