Hi Jonathan,

Xforms elements do get rendered out with labels (whether these labels are output correctly from an accessiblity perspective is another matter). If you look at this example: 

http://alloy.uk.episerver.com/About-us/Become-a-reseller/

The Radio buttons have Label elements, and there's also mark-up relating to validation messages.  

In terms of making Mandatory fields highly visible, I'm not sure what would be acceptable from a Screen-reader perspective, but I'm guessing you could:

1. Hook into the BeforeLoadingForm event and modify the mark-up, as per this example: http://www.frederikvig.com/2010/11/semantic-markup-with-episerver-xforms/
2. Apply css to all fields with validation (the validation message is output in a span tag with class "xformvalidator"
3. Supply a custom css class when adding the form field within the xform builder. 

Hope this helps

Mark