The original image was posted September 11, 2012 by user @Anna-Autobot12 to DeviantART but it found an unexpected resurgence of popularity in January 2022 as a result of sudden popularity on sptwt and Tiktok. It also spread to the Official South Park Discord, where it was removed by moderators repeatedly for breaking rules against art theft as well as shipping. In all settings, it was often posted by non-Kyman shippers who were posting it ironically to parody Kyman shippers while nonetheless spreading depictions of the ship.
The image was soon used as a basis for derivative art, such as Randy Marsh confronting Gerald Broflovski with "Hey Jewrald", and resulted in hundreds of derivatives, generally switching Cartman or Kyle for other characters and the 'Jew' replaced with various other descriptive terms, though kept if the character in question is Jewish. This eventually evolved to include a wide variety of ships, including multiple instances of Ike and Ms. Stevenson, an adult/child ship. Here is an example Twitter thread containing dozens of examples of the meme.
The original author of the image was criticized on Twitter for having drawn art of herself hanging out with Kenny McCormick, with a user pointing out she was sixteen at the time and he is ten years old and that the art seemed suggestive. This did not appear to affect the popularity of the meme as it continued to spread throughout the online community.