Personally I think that even if the training data, is made of images of people who are over 18, the state of the adult industry is that there is a lot of harm and exploitation involved in that even. Do we have the evidence necessary to prove every over 18 person who's images are in the training data are okay with that use? So there is no somehow-okay anything. But if were dealing with models that can combine concepts .. then "adult" + "sex" = "sexualized adult" so "child" + "sex" = "sexualized child" .. this is just a fundamental capability of the technology. Without even getting into nudity where its easy to see how non CSAM, non-sexualize medical images etc, can fill in the gaps for the model. This is why I think just calling it CSAM is confusing the arguments. I see the base harm as being the promotion of sexualization of children. And this is more a harm and risk to society and to people consuming these images. Of course if you extend this to "real childs image" + "sex" to get a sexualized deepfake then there is a kind of harm to that individual too, but its still a disctint thing from physical abuse.. This is just my instincts on this but I'd be really interested to see some real discussion between people with actual extensive understand and experience of all these areas.