Ed the Happy Clown is a graphic novel by Canadian cartoonist Chester Brown. Its title character is a large-headed, childlike children's clown who undergoes one horrifying affliction after another. The story is a dark, humorous mix of genres and features scatological humour, sex, body horror, extreme graphic violence, and blasphemous religious imagery. Central to the plot are a man who cannot stop defecating; the head of a miniature, other-dimensional Ronald Reagan attached to the head of Ed's penis; and a female vampire who seeks revenge on her adulterous lover who had murdered her to escape his sins.
Summary
The children's hospital Ed is about to visit burns down with all the children in it. A number of apparently unrelated short gag strips appear  before Brown begins to tie the narrative together into one plot.  Ed is imprisoned when he finds hospital janitor Chet Doodley's severed hand and the police assume Ed had taken it. In the prison a man is unable stop defecating and his faeces fill the jail, engulfing all, including Ed. When Ed emerges he finds the head of his penis replaced with the head of a miniature Ronald Reagan from Dimension X--a world much like Ed's but whose people are tiny. Dimension X has dumped its waste into a trans-dimensional portal, which turns out to be the anus of the man who could not stop defecating. Reagan's body remains in Dimension X, and the professor who discovered the portal travels to Ed's dimension to find the head, making contact with the authorities of Ed's world.  Chet believes the loss of his hand is due to his unfaithfulness to his wife; as a child his mother read Chet the story of a Saint Justin who cuts off his right hand to avoid sinning, and Chet assumes his lost hand is a like punishment from God. He tries to atone for it by killing his girlfriend, Josie, in the woods. Penis-worshipping, rat-eating pygmy cannibals drag the bodies of both Josie and Ed into the sewers. As they are about to sever Ed's penis Josie reanimates in time to save him. The two attempt to escape from the sewers when they are accidentally shot by a mother-daughter team of pygmy hunters. Josie dies again, and her disembodied spirit learns from the ghost of Chet's sister that she has become a vampire.  The professor from Dimension X and members of the staff of the Adventures in Science TV show find Ed and the President and bring them to the TV studio. The discovery is big news, and the professor and the President make a TV appearance. When it is discovered that the people of Dimension X are homosexual or bisexual the professor is put to a violent death, and Ed and the body of Josie are put in confinement. The studio is invaded by the pygmies when they recognize their "Penis God" on television. Josie's spirit returns to her body, and she and Ed escape and make their way to the hospital where Chet works. Josie gets her revenge by seducing Chet and killing him before he is able to repent, thus sending him to Hell.  Ed is one of a number of men secretly kidnapped to provide another, Bick Backman, with a penis transplant--a larger one to please his wife. Out of the lineup of unconscious men, Ed's penis with the President's head on it stands out and is chosen for Backman. After the operation, Mounties raid the hospital and, finding Reagan, take Backman and leave Ed, who has had a larger penis sewn on in the President's place. The hospital hands Ed over to Mrs Backman, claiming he is her husband. Though suspicious, she accepts Ed--and his newly transplanted penis.

Q: who are some of the characters?
A: Ed is imprisoned when he finds hospital janitor Chet Doodley's severed hand

Q: what is the setting of the story?
A: unknown

Q: what are aspects of the story that contain Reagan?
A: the head of his penis replaced with the head of a miniature Ronald Reagan from Dimension X

Q: what are some other notable elements in the summary?
A: Penis-worshipping, rat-eating pygmy cannibals drag the bodies of both Josie and Ed into the sewers.

Q: what are elements of canibalism?
A: Penis-worshipping, rat-eating pygmy cannibals
what other elements of sexuality were described?
Josie gets her revenge by seducing Chet and killing him before he is able to repent, thus sending him to Hell.
Josie gets her revenge by seducing Chet and killing him before he is able to repent, thus sending him to Hell.