It's not like I'm going to stay up into the night because some anon was fantasizing about getting a blowjob from a baby, but if the choice is "fucked up fictional thing" and "fucked up nonfiction thing", it's sort of obvious which I'm going to find more disturbing.
If it looks ironic, then it doesn't bother me. Like I said, if something's TRYING to be disturbing, then fundamentally it means the author found it disturbing as well.
If someone says "child abuse disturbs me", are you disturbed? I don't think so.
If someone says "child abuse disturbs me" by making a really grim comic about it, that's still the same message. The comic "Clarissa" was mentioned in this thread. I find the comic sad and dark, but I wouldn't say I'm "disturbed" by it, because the creator clearly finds abuse disturbing and wanted to share that emotion with an audience. What is there to be disturbed about?
If someone says "child abuse gets me hard", and draws a comic trying to convey THAT, the warped nature of the storytelling would probably disturb me in a very different way.