What a screen reader announces
Nothing on a page tells you that your alt text is spoken with a word in front of it. Almost every common alt-text mistake is a collision with that one fact.
The announcement has three parts, and you write one
When a screen reader reaches an image with a non-empty alt attribute, it does not read your sentence. It reads a role, then your sentence, and then — depending on where the image sits — some context about the element around it. The role is a word like “graphic” or “image”, chosen by the software rather than by you, and it arrives before anything you wrote.
So the string a listener actually hears from alt=“Photo of a red bicycle” is closer to “graphic, photo of a red bicycle”. The category is announced twice: once by the software and once by you. It is a small cost on one image and a steady tax across a page of forty.
Everything below follows from that. The tool on this site strips those openings for you because it is the one edit that cannot change your meaning, and it is the most common finding on any real page.
What each one adds
NVDA on Windows
Announces “graphic” and then the alt text. Inside a link it announces the link first, so a linked image reads as link, graphic, then your words — which is why the alt text of a linked image should describe the destination rather than the picture. With no alt attribute at all, NVDA will frequently read the file name, which is how a page ends up saying “graphic, I M G underscore four zero two one dot J P G”.
JAWS on Windows
Similar, with more configuration behind it. Verbosity settings change how much context comes with an image and long-standing users often run them low. Graphics with no alternative can be announced by file name, by a hash, or skipped entirely depending on those settings — so the failure mode varies between two people using the same software on the same page.
VoiceOver on macOS and iOS
Announces “image” and the alt text, and on iOS an image inside a link becomes a single element the user swipes to, with the role and the name read together. The image rotor lists every image on a page by its accessible name — which is a good test of your own work, because a list of names with no surrounding sentence shows immediately which of them say nothing.