My Dad's side of the family is so big that after most of his siblings were in their 20's and married, doing even a gift exchange where you get someone else's name became hard to organize.
So they had a couple of years off, then they did an "exhange" where you write a poem, song or story about the person who's name you get. Which was pretty fun. The following year we went with the white elephant exchange, and it's going to be on it's 5th year this year. Participation is obviously optional, so if don't have the time/funds to purchase a $20 gift, that's okay.
Usually a couple of people end up giving a bottle of nice liquor/wine, then maybe some useful objects from a store like pier 1 imports, and someone usually does a couple of movies with some popcorn and other snacks... You'd be surprised how much fun it ends up being. It's not even what you get if you have a fun family. In only 3 years we had to write out the rules before we could do it because a couple of gifts would just circle around and around until someone gave up.
You really have to go with a rule where a gift can only be stolen once each round... This gives everyone a "fair" chance at it. We also decided that it's strictly your choice to decide if you want to open it and show off what it is, or if you want to keep it wrapped and hope you know so people are less likely to take it. It's a real riot.
The only hard thing is to find an item that ANYONE would want (male or female) and making sure you keep everything in good spirit. It's okay to give a funny gift but just make sure no one feels cheated. Dog toys or something would be rude, but a Wooley Willy, Army Men, Coloring books and crayons as one gift would be funny. You can't get upset if you get a lower value gift or something you might not really want. Like I said, the exchange is more fun than the fact that you are getting someone if everything goes right.
