I think my best option is to write Python scripts with Dragonfly [0] to make a Visual Studio or VS Code extension that gives me accessibility, and/or a neovim plugin to let me say vim commands efficiently.
Dictating plaintext and copy/pasting works for writing code, but navigating through VS menus and code files and e.g. running unit tests is still a nightmare. Maybe an accessible mouse would help.
It sounds niche, but Visual Studio is perhaps the most popular IDE, and Dragon is the only real option for voice access on PCs. Any programmer without use of her hands would need this. It suggests that none of the programmers on the Dragon team have really dogfooded their product, at least for accessibility.
What I find truly heinous though is the Chrome plugin. It has two stars and thousands of reviews, and either doesn't work at all or breaks minutes in. When it works it's great, but it almost never does.