Dealing with Prejudice and -isms on an in-game level

Storytellers who run games set in earlier times or modern places where sexism, racism, classism and homophobia rear their ugly heads are likely to consider the question: "Should I go with realism or escapism?" 

On the plus side, realistically depicting the nastier side of world history is not only more realistic but can actually help educate people on the realities faced by large swathes of the population.  On the negative side, a lot of people play characters like themselves and this means that you're less likely to be introducing players to what it would be like to deal with sexism and racism for the first time in their lives.  You're more likely to be confronting someone who's already dealt with it (though hopefully to a far lesser degree) in their lives.  They might not want to have to face the same real world struggles over and over in the game.  They are playing a game to deal with something different after all.

There's three main choices I can see (though feel free to comment on more):

You can ignore the -isms or at least relegate it to the sidelines so that only unlikable characters demonstrate it and then only rarely.  There is nothing wrong with this approach, especially if any of your players are uncomfortable with the opposite.  There's nothing worse than being part of a discriminated group in real life and then having the rest of your player base peer pressure you into facing that discrimination during your hobby as well.

You can play it realistically with characters encountering both so-called 'well meaning -isms' ("You shouldn't go in there, ma'am.  It's not something a lady should see.") to prejudicial cruelty ("This is no place for a woman.  I will not have you undermine my word, little lady.  If you try to go in there, I will knock you flat.")  In this case, it's best to ensure that you're not unfairly biasing the actual play experience in favor of one group or the other.  In other words, if female characters have to sit out scenes in gentleman's clubs than male characters have to sit out scenes in maternity wards.  Anything else will unbalance the game and actually undermine the player's enjoyment.  You can read more about this idea and this question at the Yog-Sothoth forums.

Finally, you could make a point of it.  If you want to really boost the immersion factor of the roughness of another era, why not make it all the more obvious by inverting the groups?  Change nothing but the colour of the skin or the genders.  Yes, it's artificial but it's the kind of artificial that can really underline the experience of what it's like to have your genetalia or skin pigmentation define them as inferior.  Alternatively, you could have men playing female characters and women playing male ones to see it from the other perspective, though this won't necessarily be as effective.

What do you guys think?  Dealt with this yourself?  Any ideas on how else you could deal with it?