One thing that would help with the gag gifts is my suggestion below, which was very poorly (and rudely on the part of one LJ staffer) received on LJ--that people should be able to block V-gifts from anonymous users and non-trusted users.

I would feel far more relaxed about steaming bags of poo if I knew they were only coming from people I'd granted access to; and ANY gift, no matter how nice, can be made creepy and offensive--I not only don't mind the occasional flaming bag of poo from a close friend, but also DO NOT WANT roses from my crazy ex on Valentine's Day.