Consider there's a strong selection bias at play in your experiences. The ones most at risk of falling into a trap like this are the ones who are likely least visible to others. Also yes, I think it will be worse for women but I'm not 100% certain.
Whether or not the usage is problematic is a separate question. I don't think anything rises to the level of "sharing fake nudes of a real person" and I suspect the effort of having a conversation is a natural limiter, but now I'm the one speculating.
sigh. I really hope someday people can achieve sufficient emotional strength to realize that it can't take anything away from you that someone can take a photograph of your face and create arbitrary fictional imagery from it.
It's been possible since realistic painting was mastered, and yes now it's far easier. But it still isn't real. People shouldn't let it affect them any more than fictional text. I can write "<insert moviestar> does <insert shocking sex act> on <insert shocking other person>" and it doesn't mean they did the act or that anyone should even care about that stupid sentence. It's make-believe.
Now in the case they keep it private, you'll never know and never be bothered by it, but the issue is people tend to share this stuff and build on it. Other people read it and start assuming it's real or based on some kind of truth.
When you add things like Americas fear of nudity you can start creating problems for the victims in these cases.
This 'bully' is nearly always going to be an untraceable online ghost. Raging against them and declaring yourself violated doesn't teach them a lesson, it only increases the blast radius of their mischief and makes people see themselves as helpless victims.
Also, I wish all bullies were so weak and impotent that all they can do is generate fictional, obviously-fake images. Imagine if Putin was trying to conquer a country by making mean pictures of Zelenskyy. Would be a pretty good world.