Hi Geoff,
> I would like to confirm that MathJax has no onboard speech-to-text generator-- correct?
From the rest of your message, I'm assuming you mean text-to-spech here.
> All speech is generated using a screen reader, in other words, and the settings in the Accessibility menu affect only how screen readers present math to users, and not any built-in speech generator.
I think that's correct. Technically though, speech text (and braille) can be presented visually as a subtitle but for actual voicing, users need to use a screenreader right now.
That being said, Brian Richwine at Indiana University has built a small script to pass MathJax/SRE speech output to the speech synthesis API. You can read more at
https://brichwin.pages.iu.edu/canvasBookmarklets.html. That API still has limited browser support but might be a long term solution for this.
Best,
Peter.