I fish the NF of the Clearwater in Idaho, my buddy and I are as far as I know the only two that fish with the two handers for trout. Steelhead, is a different story on the main body of the Clearwater. Dry's and streamers mostly. My buddy Tony likes skating dry's and it works well for him. Skate karma I guess.
I am up there most of the summer along with other rivers you are no doubt familiar with, and will pull my two-hand 4wt out every day or so. I started with it when I was practicing every morning with my steelhead rods, but kept a streamer on the line. I would always catch a few that way, so bought the 4wt and now fish wets, soft hackles, and streamers early in the year when the flows are higher. A buddy will sometimes join me and he also uses a two-hand rod. Surprising we both don't seem to see a lot of people doing that, considering the number of two-handers on the Clearwater, Ronde, and Snake starting in August.