Hi superfreq! Thank you for asking. I know games built in ren’py have built in text to speech for dialogue (called self-voicing). The Self-voicing mode can be toggled by pressing the v
key.
as for the buttons and image descriptions, etc, I honestly don’t think that a screen reader would do much but I’m not sure. If you have twitter, feel free to message me @incubusgame1 and I’d be happy to send you a link so you can try it if you want?
Please note though that the game is 18+ and full of men who have sex with men.