In this study, the authors address the case of STEM (science, technology, engineering, mathematics) content teachers in an English medium instruction (EMI) environment in Kazakhstan to argue that the professional needs and identities of these teachers are considerably different than the specialist English teachers who teach English language skills and grammar. Therefore, STEM teachers require a different language policy response and diagnosis, and should be understood through a different analytical lens. The study draws on qualitative interviews with one EMI expert and 58 STEM content teachers from six cities or regions of Kazakhstan to present an account of the challenges they confront within mainstream schools. Findings suggest that policies force STEM content teachers to take the role of English teachers, although they are not prepared for that role. These teachers emphasize that their main responsibility is to teach course content, not the English language. As a result, they undergo several dilemmas such as professional [dis]investment and identity crisis, linguistic disadvantages, inferiority complexes, and pedagogical and theoretical limitations. Top-down policies render local teachers and practitioners voiceless and disconnected from policymaking. The authors propose a non-traditional, participatory, and non-hierarchical policy framework, where policy actors at different levels collaboratively engage to assess teachers' diverse needs and take contextually informed actions to address the afore-stated dilemmas and challenges.