There are also tours normally geared towards Chinese tourists, but that are staffed with English-speakers (both the Chinese tour guide and the North Korean guid

There are also tours normally geared towards Chinese tourists, but that are staffed with English-speakers (both the Chinese tour guide and the North Korean guides/handlers), so English-speaking Westerners can get a heavily controlled tour that's just a bit less controlled than the one typically offered to Westerners. The crossing into NK is made at Dandong in China, and after crossing the river, you take a regular internal NK train to Pyongyang, instead of taking a foreigners-only plane or train direct from Beijing to Pyongyang. US citizens used to take these tours, but I think it's probably even more insane to do that nowadays.