It’s nearly an impossible question to answer in criminal scenario. An actual photo of an exposed minor is clearly harm to that individual. Putting their face on a fake but believable body is nearly as bad. Then you get to the sort of 5-10% gap where it could be them or inspired by them, but few would believe it’s an actual photograph. It all goes downhill from there. Cartoonify someone, give them bigger boobs and put them in a bikini on Mars and we start to wonder how this got to trial. It would be a huge gift to lawyers but I think most of this needs to play out in civil courts.