Introduction: Sexual and Reproductive Health (SRH) education in Malaysia remains a sensitive and complex issue due to the nation’s diverse religious beliefs, cultural norms, and societal stigmas. Parents are critical in shaping adolescents' SRH knowledge, yet many face challenges due to insufficient knowledge, skills, and confidence. This study aims to explore these challenges and develop a culturally sensitive SRH education framework tailored to Malaysian families. Materials and methods: A three-phase methodology was employed. Phase 1 consisted of qualitative interviews with 31 parents (9 fathers, 22 mothers) from diverse academic and socioeconomic backgrounds. Participants were recruited through non-governmental organisations (NGOs), religious institutions, parenting workshops, and snowballing methods in six states. Phase 2 involved a critical discourse analysis of two key resources: the government’s Cakna Diri module and the self-help book Berbual-bual dengan Anak Tentang Seksualiti. Phase 3 focused on developing and validating a culturally sensitive SRH framework. Thirteen experts, including religious scholars, healthcare professionals, and child advocates, evaluated the framework using the Fuzzy Delphi Method. Results: Phase 1 identified three key themes: (1) The Influence of Religion and Culture in SRH Education, (2) Parents’ Attitudes and Practices in Delivering SRH Education, and (3) Issues and Challenges in SRH Education Among Parents. Phase 2 highlighted content gaps and delivery issues in the Cakna Diri module, recommending improvements such as clearer objectives, practical adult learning principles, and coverage of topics like internet safety, masturbation, and pornography. Analysis of Berbual-bual dengan Anak Tentang Seksualiti provided additional insights for framework refinement. Phase 3 concluded in the validation of a culturally sensitive SRH framework. Of 36 proposed criteria, 34 achieved high consensus (0.831–0.967). Rejected elements included men-cantered approaches (d=0.587) and framing repentance as a primary focus (d=0.241). Conclusion: This study highlights the critical role of religion, culture, and systemic challenges in shaping SRH education in Malaysia. The validated framework empowers parents with practical, culturally appropriate strategies and promotes collaboration among schools, parents, and healthcare providers, offering a path to improve SRH education and adolescent well-being.