It's not intuitive to humans, even after learning parsing theory. I can do basic name refactorings. I've even written neovim plugins to do 1 specific thing with the AST (dfs down and delete one subtree which I understand). Those are fine.

I would not be comfortable doing an on-the-fly "rewrite all subtrees that match this pattern" kind of edit.

It seems like a tool that's good for LLM's though.

"rewrite all subtrees that match this pattern" works really well in jetbrains, they call it structure search-and-replace.