Not on Linux- the accessibility scene is pretty abysmal and even then, the screen readers I used didn't have OCR. (Plus there's OCR taking more battery, which isn't immaterial)

I think I don't consider it a dilemma, but I am imagining other people see it as such and I am trying to inquire about how people internalize it / think about alt text.

I do think censoring the slur in the screenshot is the way to go (and so also noting the pixelated and implied slur in the alt text)