I'm not happy with the ESRB. I've been arguing in the IGDA forum about it. I'm probably being a big jerk but, hey, you work with what you know.
http://www.esrb.org/esrbratings_faqs.asp#3 is a description of their ratings process. They keep the questionnaires and requirements a secret.
Let me review:
You want your game rated. You talk to the ESRB. They send you a questionnaire, which you are bound to keep absolutely secret. You fill out the questionnaire and send them video copies of the "worst of the gameplay".
Then they hand that stuff over to three people who do not play video games to rate.
You are allowed to resubmit if you want a different rating.
They never play your game.
In addition, RockStar did nothing wrong, because they couldn't send these guys a video of the sex stuff - it was not part of the game.
The ESRB has done nothing but stupid shit during this fiasco, and I've been really angry at them for weeks. Now I'm even angrier.
They never even play the games they rate.