AI is not creating images in a vacuum. There is a person using it and that person does have a mind. You could come up with a brand new mythical creature right now, let’s call it AI-saurus. If you ask it to create a picture of AI-saurus, it wouldn’t be able to do so because it has no idea what it looks like. However what you could do is describe it to the AI and it’ll output something that more or less resembles what you had in mind. What ever flaws you see in it you could correct for with a new, modified prompt and you keep doing this untill it produces something that matches the idea you had in mind. AI is like a police sketch artist; the outcome depends on how well you managed to describe the subject. The artist itself doesn’t need to know what they looked like. They have a basic understanding of human facial anatomy and you’re filling in the blanks. This is what generative AI does as well.

The people creating pictures of underage kids with AI are not asking for it to produce CSAM. It would most likely refuse to do so and may even report you. Instead, they’re describing what they want the output to look like and they’re arriving to the same end result by just using a different route.